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Efimov I, Agricola CJ, Nienhaus A, Harth V, Zyriax BC, Mache S. Stress perception, coping behaviors and work-privacy conflict of student midwives in times of COVID-19 pandemic: the "Healthy MidStudents" study in Germany. BMC Health Serv Res 2024; 24:594. [PMID: 38714981 PMCID: PMC11075225 DOI: 10.1186/s12913-024-10823-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 03/04/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Student midwives deliver care for women under challenging job demands, which may affect their mental health- thus creating a high need for health promotion. Given the lack of research addressing this topic, the aim of this study is to examine the links between stress perception, coping behaviors, work-privacy conflict, and perception of COVID-19 pandemic impact on studies of student midwives in northern Germany. METHODS Data were collected using a cross-sectional online-survey at nine midwifery study sites in northern Germany from October 2022 to January 2023. 342 student midwives (response rate: 61.3%) were surveyed on stress perception, coping behaviors, work-privacy conflict, and perceived impact of the COVID-19 pandemic on their studies. Descriptive, linear regression and moderation analyses were run to test explorative assumptions. RESULTS Results revealed that higher levels of perceived stress were reported by 13.4% of student midwives. Social support (M = 13.76, SD = 2.19) and active stress coping (M = 10.72, SD = 2.01) were identified as most prevalent coping behaviors in the present sample. It was found that work-privacy conflict was positively associated with stress perception (ß = 0.53, p =.001) and maladaptive coping behaviors (alcohol and cigarette consumption: ß = 0.14, p =.015), and negatively associated with adaptive coping behaviors (positive thinking: ß = - 0.25, p =.001, social support: ß = - 0.23, p =.001). Students with children reported significantly lower levels of social support than students without children. 55.6% of student midwives perceived a negative impact of the COVID-19 pandemic on their studies (mostly on lectures, seminars, and contact with fellow students). CONCLUSIONS Key findings highlighted moderate stress levels among student midwives during theoretical study stage. Based on current research, prevalence of high stress levels among student midwives remains unclear. Given the overall heterogeneous, limited research on student midwives' stress perception, coping behaviors, work-privacy conflict and perceptions of COVID-19 pandemic impact on studies, implications for research are suggested, e.g. longitudinal studies at different time points and settings and interventional studies. Findings provide a starting point for implementation of workplace health promotion in theoretical and practical stages of midwifery science study programs, e.g. training courses on stress prevention and adaptive coping, and for improvement of working conditions.
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Affiliation(s)
- Ilona Efimov
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Seewartenstr. 10, 20459, Hamburg, Germany.
| | - Caroline Johanna Agricola
- Midwifery Science Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Albert Nienhaus
- Competence Center for Epidemiology and Health Services Research for Healthcare Professionals, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Seewartenstr. 10, 20459, Hamburg, Germany
| | - Birgit-Christiane Zyriax
- Midwifery Science Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Stefanie Mache
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Seewartenstr. 10, 20459, Hamburg, Germany
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Dragano N, Burr H, Formazin M, Schulz A, Rose U. [Long Working and Commuting Times as Risk Factors for Depressive Symptoms: Cross-Sectional and Longitudinal Analyses]. Gesundheitswesen 2023; 85:1016-1026. [PMID: 37972582 DOI: 10.1055/a-2090-1553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Zusammenfassung
Hintergrund Regelmäßige lange Arbeitszeiten und
Arbeitswege könnten negative Folgen für die psychische
Gesundheit haben. Die Studienergebnisse hierzu sind jedoch nicht eindeutig und
variieren nach Ländern. Die vorliegende Analyse prüft
für Deutschland Zusammenhänge zwischen langen Pendel- bzw.
Arbeitszeiten und depressiver Symptomatik.
Methode Die „Studie Mentale Gesundheit bei der Arbeit“
(S-MGA) ist eine Längsschnittuntersuchung einer Zufallsstichprobe
sozialversicherungspflichtig Beschäftigter. An der Basiserhebung nahmen
3 413 Personen teil, von denen 2 019 nach 5 Jahren erneut befragt wurden.
Wöchentliche Arbeits- und Pendelzeiten sowie Covariaten (Alter,
Geschlecht, berufliche Position, psychosoziale Arbeitsbedingungen) wurden zur
Basisuntersuchung erhoben. Depressive Symptome wurden zu beiden Messzeitpunkten
mit dem Patient Health Questionnaire (PHQ-9) erfasst. Um Zusammenhänge
zu untersuchen, wurden mittels logistischer Regression Odds Ratios mit
95%-Konfidenzintervallen unter Kontrolle von Covariaten kalkuliert. Es
wurden sowohl Querschnitts- (nur Basiserhebung) als auch
Längsschnittsanalysen (Basis- und Nacherhebung)
durchgeführt.
Ergebnisse Zur Basiserhebung hatten 7% der Beschäftigten
lange wöchentliche Arbeitszeiten von≥55 Stunden, weitere
8% arbeiteten 49 bis 54 Stunden. Im Querschnitt waren lange
Arbeitszeiten mit einer moderaten Erhöhung der depressiven Symptomatik
gegenüber der Normalarbeitszeit (35 bis<40 h/Wo)
assoziiert. Wenn die nach fünf Jahren neu auftretende depressive
Symptomatik betrachtet wurde, war der Zusammenhang für Arbeitszeiten von
55 und mehr Stunden deutlich ausgeprägt (Odds ratio (OR) 2,14;
95% Konfidenzintervall (KI) 1,11;4,12), nicht jedoch für
Arbeitszeiten von 49 bis 54 Stunden (OR 1,26, KI 0,65;2,43).
Beschäftigte, die wöchentlich zehn Stunden und mehr pendelten,
hatten im Querschnitt häufiger eine depressive Symptomatik (OR 1,83; KI
1,13;2,94) im Vergleich zur Referenzgruppe, die<2,5 Stunden pendelte.
Dieser Zusammenhang war im Längsschnitt nicht zu beobachten.
Schlussfolgerungen Die Ergebnisse legen nahe, dass überlange
Arbeits- und Pendelzeiten mit einer depressiven Symptomatik bei
Beschäftigten assoziiert sind, wobei die Effekte bzgl. Pendelzeit nur im
Querschnitt zu finden waren. Die Ergebnisse unterstreichen die Bedeutung der
Einhaltung von Arbeitszeitregelungen und der Vermeidung überlanger
Arbeitszeiten für die Mitarbeitergesundheit. Zur Rolle des Pendelns sind
weiterführende Untersuchungen nötig.
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Affiliation(s)
- Nico Dragano
- Institut für Medizinische Soziologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Hermann Burr
- Fachbereich 3 Arbeit und Gesundheit, Bundesanstalt für Arbeitsschutz und Arbeitsmedizin Standort Berlin, Berlin, Germany
| | - Maren Formazin
- Fachbereich 3 Arbeit und Gesundheit, Bundesanstalt für Arbeitsschutz und Arbeitsmedizin Standort Berlin, Berlin, Germany
| | - Anika Schulz
- Fachbereich 3 Arbeit und Gesundheit, Bundesanstalt für Arbeitsschutz und Arbeitsmedizin Standort Berlin, Berlin, Germany
| | - Uwe Rose
- Fachbereich 3 Arbeit und Gesundheit, Bundesanstalt für Arbeitsschutz und Arbeitsmedizin Standort Berlin, Berlin, Germany
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Brym S, Mack JT, Weise V, Kopp M, Steudte-Schmiedgen S, Garthus-Niegel S. Mental health of working parents during the COVID-19 pandemic: can resilience buffer the impact of psychosocial work stress on depressive symptoms? BMC Public Health 2022; 22:2426. [PMID: 36567325 PMCID: PMC9790816 DOI: 10.1186/s12889-022-14582-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 11/09/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has confronted working parents with an accumulation of stressors regarding changes in work, family, and social life, putting their mental health at risk. Stressors include altered working conditions such as working from home or changes in working hours as well as the difficulty to reconcile work and childcare due to the closure of childcare facilities. The present study examined the relationship of psychosocial work stress (i.e., work-privacy conflict and effort-reward imbalance at work) and depressive symptoms in working parents and whether this association was moderated by individual resilience. METHODS Data of the present study (n = 452) were collected in Germany between May and June 2020 as part of the DREAMCORONA study. A subsample of working mothers (n = 191) and fathers (n = 261) completed the subscale for work-privacy conflict (WPC) of the Copenhagen Psychosocial Questionnaire, the Effort-Reward Imbalance (ERI) Questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), and the Edinburgh Postnatal Depression Scale (EPDS). Multiple linear regression analyses including moderation were performed, controlling for gender, working hours per week, and a lifetime history of depression as potential confounders. RESULTS Both WPC (β = 0.336, p < .001) and ERI (β = 0.254, p < .001) were significantly associated with depressive symptoms. Resilience moderated the relationship between ERI and depressive symptoms (β = - 0.101, p = .018), indicating that higher resilience weakened the relationship. However, this effect was not found regarding the relationship between WPC and depressive symptoms (β = 0.055, p = .167). CONCLUSIONS The results highlight the need for measures to reduce psychosocial work stressors such as WPC and ERI during the COVID-19 pandemic on the one hand and to promote resilience on the other hand. The findings partially support the potential protective role of resilience buffering the association between psychosocial stress and mental health in working parents. Longitudinal studies are needed to confirm this effect.
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Affiliation(s)
- Stephanie Brym
- grid.4488.00000 0001 2111 7257Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Judith T. Mack
- grid.4488.00000 0001 2111 7257Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Victoria Weise
- grid.4488.00000 0001 2111 7257Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Marie Kopp
- grid.4488.00000 0001 2111 7257Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susann Steudte-Schmiedgen
- grid.4488.00000 0001 2111 7257Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Susan Garthus-Niegel
- grid.4488.00000 0001 2111 7257Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany ,grid.461732.5Institute for Systems Medicine and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany ,grid.418193.60000 0001 1541 4204Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
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Bodendieck E, Jung FU, Luppa M, Riedel-Heller SG. Burnout and work-privacy conflict - are there differences between full-time and part-time physicians? BMC Health Serv Res 2022; 22:1082. [PMID: 36002851 PMCID: PMC9404597 DOI: 10.1186/s12913-022-08471-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/18/2022] [Indexed: 12/01/2022] Open
Abstract
Background Changes in everyday work with regard to working time models have reached the medical profession. The number of physicians working part-time is steadily increasing. At the same time, however, the population's need for care is also rising. This can reinforce the impending shortage of doctors in the future. The aim was to investigate differences in work-privacy conflict and burnout among physicians working full-time or part-time. Method The present study includes data from a baseline survey of the long-term study of physicians with different medical backgrounds. The analysis focused on a sub-sample of 598 physicians (not self-employed). The two main outcomes under investigation—burnout and work-privacy conflict—were measured using the Copenhagen Burnout Inventory adapted for health care professionals, as well as the associated subscale of the Copenhagen Psychosocial Questionnaire (COPSOQ). Data analyses included descriptive statistics followed by regression models. Results Descriptive analyses show, that 31.8% of physicians are working part-time, whereas 68.2% are working full-time. The part-time subsample is significantly older, and female physicians are more likely to work part-time. With regard to workload and work-privacy conflict, significant differences between part-time and full-time physicians were only observed in terms of work-privacy-conflict. However, regression analysis underline the importance of possible confounding variables (such as medical setting) within the relationship between job size and job-related well-being. Discussion Differences in working hour arrangements (full-time or part-time work) are only accompanied by less work-privacy conflict. No differences with regard to burnout (patient-related, work-related or personal) could be obtained. Rather, the data suggests that other job-related variables may play a role and should be further investigated.
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Affiliation(s)
- E Bodendieck
- General Practice, Dresdner Straße 34a, 04808, Wurzen, Germany
| | - F U Jung
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Germany.
| | - M Luppa
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - S G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Germany
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Göbel J, Schmidt M, Seifried-Dübon T, Linden K, Degen L, Rind E, Eilerts AL, Pieper C, Grot M, Werners B, Schröder V, Jöckel KH, Rieger MA, Weltermann BM, On Behalf Of The IMPROVEjob Consortium. Higher Work-Privacy Conflict and Lower Job Satisfaction in GP Leaders and Practice Assistants Working Full-Time Compared to Part-Time: Results of the IMPROVEjob Study. Int J Environ Res Public Health 2022; 19. [PMID: 35270317 DOI: 10.3390/ijerph19052618] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/23/2022]
Abstract
Background: Work-privacy conflict (WPC) has become an important issue for medical professionals. The cluster-randomized controlled IMPROVEjob study aimed at improving job satisfaction (primary outcome), with additional outcomes such as examining the work-privacy conflict in German general practice personnel. Using baseline data of this study, the relationship between work-privacy conflict and job satisfaction (JS) was analyzed. In addition, factors associated with higher WPC were identified. Methods: At baseline, 366 participants (general practitioners (GPs) in leadership positions, employed general practitioners, and practice assistants) from 60 German practices completed a questionnaire addressing socio-demographic data and job characteristics. Standardized scales from the German version of the COPSOQ III requested data concerning job satisfaction and work-privacy conflict. Both scores range from 0 (lowest) to 100 (highest). Multilevel analysis accounted for the clustered data. Statistical analyses were performed using IBM SPSS and RStudio software, with a significance level set at p < 0.05. Results: Job satisfaction was 77.16 (mean value; SD = 14.30) among GPs in leadership positions (n = 84), 79.61 (SD = 12.85) in employed GPs (n = 28), and 72.58 (SD = 14.42) in practice assistants (n = 254). Mean values for the WPC-scale were higher for professionals with more responsibilities: GPs in leadership positions scored highest with 64.03 (SD = 29.96), followed by employed physicians (M = 45.54, SD =30.28), and practice assistants (M = 32.67, SD = 27.41). General practitioners and practice assistants working full-time reported significantly higher work-privacy conflict than those working part-time (p < 0.05). In a multilevel analysis, work-privacy conflict was significantly associated with job satisfaction (p < 0.001). A multiple regression analysis identified working hours, as well as and being a practice owner or an employed physician as factors significantly influencing WPC. Discussion: WPC was high among general practice leaders and practice personnel working full-time. Future interventions to support practice personnel should focus on reducing WPC, as there is good evidence of its effects on job satisfaction.
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K R, S J, F L, A S, P W, N A, A S, J H, K RS, S L, M RW, M N, M BE, N P, K L, T M, A P, U L. Long working hours and risk of cardiovascular outcomes and diabetes type II: five-year follow-up of the Gutenberg Health Study (GHS). Int Arch Occup Environ Health 2022; 95:303-312. [PMID: 34767077 PMCID: PMC8755657 DOI: 10.1007/s00420-021-01786-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/24/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aims of this study were to determine if there was an increased risk of incident cardiovascular disease (CVD) and diabetes and an increase in arterial stiffness in participants who reported working 41-54 h per week and more than 55 h compared to those who worked 40 h or less over a time interval of 5 years. METHODS In a subsample of the population-based prospective Gutenberg Health Study (GHS) study, we examined working participants younger than 65 years at baseline (n = 7241) and after 5 years. To test the association of working time at baseline and incident cardiovascular events and diabetes type II, we estimated hazard ratios (HR) using competing risks models. For a change in the arterial stiffness index (SI) based on assessment using a Pulse Trace PCA2 device, we used multivariate linear regression models. RESULTS The SI increased in those working more than 55 h per week (beta coefficiant = 0.32 m/s (95% CI 0.07-0.58) compared to those working 40 h and less after adjustment for sex, age and SES. Due to small numbers there was no significant association of working hours and clinically manifest cardiovascular events and diabetes type II in the 5-year follow-up time. CONCLUSIONS Further studies are needed to confirm the results on working hours and arterial stiffness. Analyses of the 10-year follow-up with more events may clarify the results for incident cardiovascular events and metabolic outcomes.
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Affiliation(s)
- Rossnagel K
- Federal Institute for Occupational Safety and Health, Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA), Nöldnerstr. 40-42, 10317, Berlin, Germany.
| | - Jankowiak S
- Federal Institute for Occupational Safety and Health, Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA), Nöldnerstr. 40-42, 10317, Berlin, Germany
| | - Liebers F
- Federal Institute for Occupational Safety and Health, Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA), Nöldnerstr. 40-42, 10317, Berlin, Germany
| | - Schulz A
- University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Wild P
- University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Arnold N
- University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Seidler A
- Institute and Polyclinic of Occupational and Social Medicine (IPAS), Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Hegewald J
- Institute and Polyclinic of Occupational and Social Medicine (IPAS), Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
- Institute of Sociology, Faculty of Behavioral and Social Sciences, TU Chemnitz, Chemnitz, Germany
| | - Romero Starke K
- Institute and Polyclinic of Occupational and Social Medicine (IPAS), Carl Gustav Carus Faculty of Medicine, TU Dresden, Dresden, Germany
- Institute of Sociology, Faculty of Behavioral and Social Sciences, TU Chemnitz, Chemnitz, Germany
| | - Letzel S
- Institute of Occupational, Social, and Environmental Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Riechmann-Wolf M
- Institute of Occupational, Social, and Environmental Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Nübling M
- FFAW: The Freiburg Research Centre for Occupational Sciences, Freiburg, Germany
| | - Beut-El M
- University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Pfeiffer N
- University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Lackner K
- University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Münzel T
- University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Poplawski A
- University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Latza U
- Federal Institute for Occupational Safety and Health, Bundesanstalt für Arbeitsschutz und Arbeitsmedizin (BAuA), Nöldnerstr. 40-42, 10317, Berlin, Germany
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7
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Hegewald J, Romero Starke K, Garthus-Niegel S, Schulz A, Nübling M, Latza U, Jankowiak S, Liebers F, Rossnagel K, Riechmann-Wolf M, Letzel S, Arnold N, Beutel M, Gianicolo E, Pfeiffer N, Lackner K, Münzel T, Wild P, Seidler A. Work-life conflict and cardiovascular health: 5-year follow-up of the Gutenberg Health Study. PLoS One 2021; 16:e0251260. [PMID: 33961688 PMCID: PMC8104925 DOI: 10.1371/journal.pone.0251260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/23/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Work-life conflicts (WLC) may impact health, but few studies prospectively consider the impact of WLC on objective outcomes such as cardiovascular disease. Using data from the Gutenberg Health Study (GHS), we examined if WLC at baseline was associated with an increased five-year incidence of cardiovascular events (myocardial infarct, stroke, atrial fibrillation, peripheral artery disease, coronary artery disease, chronic heart failure, sudden cardiac death). We also considered if WLC was associated with incident hypertension and arterial stiffness and if the effects of WLC on cardiovascular health differ for men and women. METHODS A working subsample of the 15,010 GHS cohort participants completed the Copenhagen Psychosocial Questionnaire, which included five "work-privacy conflict" questions at baseline and at the five-year follow-up. Relative risks for incident hypertension due to increased WLC at baseline (WLC scores exceeding 60 out of 100) were estimated with Poisson regression in the subgroup of participants without hypertension at baseline (n = 2426). Categories of WLC at baseline and follow-up were also used to examine the risk of hypertension due to chronic/recurrent WLC. In this subgroup, we also examined the association between WLC as a continuous score ranging from 0 to 100 with change to arterial stiffness after five years using linear regression. Hazard ratios were estimated for incident cardiovascular events in a larger subsample of participants without prevalent cardiovascular disease at baseline (n = 3698) using Cox regression. We used various multivariable regression models to adjust for sex, age, socioeconomic status, occupational, household, and cardiovascular risk factors. RESULTS We found no association between WLC and incident hypertension or increased arterial stiffness. The fully-adjusted relative risk for WLC >60 at baseline and hypertension was 0.93 (95% 0.74-1.17). The risk of hypertension due to chronic/recurrent WLC >60 was increased but not statistically significant (RR = 1.13, 95% CI 0.83-1.54). Overall, hazard ratios for incident cardiovascular events were also not increased. However, stratifying the results by sex resulted in a hazard ratio of 1.47 (95% CI 0.54-3.98) for incident cardiovascular disease among women in the fully adjusted model. CONCLUSIONS Although our results were not statistically significant, they indicate that WLC is negatively impacting the cardiovascular health of women. While these results need to be confirmed with additional research and a longer follow-up, interventions to prevent WLC will promote health and could be especially beneficial for women.
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Affiliation(s)
- Janice Hegewald
- Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, TU Dresden, Germany
- Institute of Sociology, Faculty of Behavioral and Social Sciences, TU Chemnitz, Chemnitz, Germany
| | - Karla Romero Starke
- Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, TU Dresden, Germany
- Institute of Sociology, Faculty of Behavioral and Social Sciences, TU Chemnitz, Chemnitz, Germany
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, TU Dresden, Germany
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Andreas Schulz
- University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Matthias Nübling
- FFAW: The Freiburg Research Centre for Occupational Sciences, Freiburg, Germany
| | - Ute Latza
- Division Work and Health, Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Sylvia Jankowiak
- Division Work and Health, Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Falk Liebers
- Division Work and Health, Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Karin Rossnagel
- Division Work and Health, Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Merle Riechmann-Wolf
- Institute for Teachers’ Health, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Stephan Letzel
- Institute of Occupational, Social, Environmental Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Natalie Arnold
- Center for Cardiology I, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
- Department of Medicine 2, Preventive Cardiology and Preventive Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Manfred Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Emilio Gianicolo
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Institute of Clinical Physiology, National Research Council, Lecce, Italy
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Karl Lackner
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology I, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany
| | - Philipp Wild
- Department of Medicine 2, Preventive Cardiology and Preventive Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany
- Center of Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Mainz, Germany
| | - Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, TU Dresden, Germany
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Fischer JE, Genser B, Nauroth P, Litaker D, Mauss D. Estimating the potential reduction in future sickness absence from optimizing group-level psychosocial work characteristics: a prospective, multicenter cohort study in German industrial settings. J Occup Med Toxicol 2020; 15:33. [PMID: 33292316 PMCID: PMC7664018 DOI: 10.1186/s12995-020-00284-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Absence from work due to sickness impairs organizational productivity and performance. Even in organizations with perfect work conditions, some inevitable baseline sickness absence exists amongst working populations. The excess sickness absence observed above this baseline rate has become the focus of traditional health promotion efforts, addressing preventable physical illness, health behavior and mental health at the personal level. However, a health and safety approach following the TOP-rule would consider work-group psychosocial work characteristics as a potential risk factor amenable to organizational measures. To date, there is a scarcity of studies relating psychosocial work characteristics to possible reduction of excess sickness-absence rates. METHODS We aimed to estimate the potentially avoidable excess fraction of absence attributable to work-group psychosocial characteristics. We considered work-group averaged perception of psychosocial work characteristics as a proxy to the methodologically elusive objective assessment of organizational characteristics. Participants were recruited from multiple sites of a German automotive manufacturer with individuals nested within work groups. We predicted 12-month follow-up work-group sickness absence rates using data from a baseline comprehensive health examination assessing work characteristics, health behavior, and biomedical risk factors. We considered the quartile of work-groups yielding favorable psychosocial work characteristics as a realistic existing benchmark. Using the population attributable fraction method we estimated the potentially amenable sickness absence from improving work-group psychosocial characteristics. RESULTS Data from 3992 eligible participants from 29 work groups were analyzed (39% participation rate, average age 41.4 years (SD = 10.3 years), 89.9% males and 49% manual workers.). Work-group absence rates at follow up varied from 2.1 to 8.9% (mean 5.1%, 11.7 missed days). A prediction model of seven psychosocial work characteristics at the work group level explained 70% of the variance of future absence rates. The estimated reduction from improving psychosocial work characteristics to the benchmark level amounted to 32% of all sickness absence, compared to a 31% reduction from eliminating health behavioral and medical risk factors to the benchmark target. CONCLUSIONS Psychosocial characteristics at the work-group level account for a relevant proportion of all sickness absence. Health promotion interventions should therefore address psychosocial characteristics at the work group level.
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Affiliation(s)
- Joachim E Fischer
- Mannheim Institute of Public Health, Mannheim Medical Faculty, University of Heidelberg, Ludolf-Krehl-Str. 7-11, 68167, Mannheim, Germany.
| | - Bernd Genser
- Mannheim Institute of Public Health, Mannheim Medical Faculty, University of Heidelberg, Ludolf-Krehl-Str. 7-11, 68167, Mannheim, Germany
| | - Peter Nauroth
- HealthVision GmbH, Hans-Bunte-Str. 8-10, 69123, Heidelberg, Germany
| | - David Litaker
- Mannheim Institute of Public Health, Mannheim Medical Faculty, University of Heidelberg, Ludolf-Krehl-Str. 7-11, 68167, Mannheim, Germany
| | - Daniel Mauss
- Mannheim Institute of Public Health, Mannheim Medical Faculty, University of Heidelberg, Ludolf-Krehl-Str. 7-11, 68167, Mannheim, Germany
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Karl M, Schaber R, Kress V, Kopp M, Martini J, Weidner K, Garthus-Niegel S. Precarious working conditions and psychosocial work stress act as a risk factor for symptoms of postpartum depression during maternity leave: results from a longitudinal cohort study. BMC Public Health 2020; 20:1505. [PMID: 33023543 PMCID: PMC7539402 DOI: 10.1186/s12889-020-09573-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/21/2020] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The majority of Western women work during their reproductive years, but past research has often neglected the influence of work-related factors on postpartum mental health. Especially postpartum depression (PPD) is an enormous psychological burden for mothers. Therefore, this study aims to investigate the prospective impact of precarious working conditions and psychosocial work stress during pregnancy (such as work-privacy conflict and effort-reward imbalance at the job) on symptoms of maternal PPD. METHODS In the prospective-longitudinal cohort study DREAM (DResdner Studie zu Elternschaft, Arbeit und Mentaler Gesundheit), N = 587 employed women were questioned about their work during pregnancy and their mental health 8 weeks after delivery. RESULTS Multiple regression analyses revealed that work-privacy conflict, low reward at work, and precarious working conditions significantly predicted symptoms of PPD, even when controlling for lifetime depression, anxiety, education, parity, and age. CONCLUSION Our results indicate that psychosocial work stress and precarious working conditions have important implications for maternal peripartum mental health. They might act as prospective risk factors for PPD during the period of maternal leave. Hence, future research should focus on preventative measures targeting work life.
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Affiliation(s)
- Marlene Karl
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Ronja Schaber
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Victoria Kress
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Marie Kopp
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Julia Martini
- Department of Psychiatry and Psychotherapy, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany. .,Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway.
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10
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Kress V, Steudte-Schmiedgen S, Kopp M, Förster A, Altus C, Schier C, Wimberger P, Kirschbaum C, von Soest T, Weidner K, Junge-Hoffmeister J, Garthus-Niegel S. The Impact of Parental Role Distributions, Work Participation, and Stress Factors on Family Health-Related Outcomes: Study Protocol of the Prospective Multi-Method Cohort "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Front Psychol 2019; 10:1273. [PMID: 31263435 PMCID: PMC6584823 DOI: 10.3389/fpsyg.2019.01273] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/14/2019] [Indexed: 12/12/2022] Open
Abstract
The Dresden Study on Parenting, Work, and Mental Health (“DResdner Studie zu Elternschaft, Arbeit, und Mentaler Gesundheit”, DREAM) aims to prospectively investigate the relationship between parental work participation, role distribution, stress factors, and their effects on perinatal outcomes and long-term family mental and somatic health in a community sample targeting N = 4,000 individuals, i.e., 2,000 couples, expecting a child and residing in Dresden, Germany (interim sample of N = 1,410 participants, recruitment ongoing). Various questionnaires are completed at four measurement points from pregnancy to 2 years postpartum (prolongation into middle childhood planned). Applying a multi-method approach, long-term endocrinological data (analyses of hair cortisol concentrations and other endogenous hormones, “DREAMHAIR”) and qualitative interview data (regarding gender role attitudes and distribution of domestic work, child care, and paid employment; “DREAMTALK”) are obtained. In this study protocol, the theoretical background, methods, and preliminary results considering sociodemographic characteristics during pregnancy and birth-related factors at 8 weeks postpartum are presented. Additionally, there is a focus on our endocrinological sub-study DREAMHAIR. In this sub-study currently comprising N = 152 participants, i.e., 88 families (recruitment ongoing), we want to gain knowledge on the transgenerational processes of stress regulation and psychopathology in the whole family by analyzing hair cortisol concentrations in both parents and children during the course from pregnancy (or after birth regarding children) to at least 2 years postpartum. By comparing data of the community sample to a clinical sample of mothers with postpartum mental disorders, their children, and their partners during the period between admission and discharge from a mother-baby unit and post-treatment (“DREAMMBU”), the course of mothers' psychopathology, parent-infant interaction, and infant regulation disorders with special regard to long-term endocrine correlates will be examined. With previous studies neglecting the fathers or partners involved, a major advantage of DREAM is the use of a multi-method and multi-level approach by examining the whole family in a longitudinal design. Therefore, the DREAM study will contribute to a better understanding of the role of social, work, and stress factors for mental and somatic health and its long-term endocrine correlates in the natural course of becoming a family.
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Affiliation(s)
- Victoria Kress
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.,Institute of Biological Psychology, Faculty of Psychology of the Technische Universität Dresden, Dresden, Germany
| | - Marie Kopp
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Anke Förster
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Caroline Altus
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Caroline Schier
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Pauline Wimberger
- Department of Gynecology and Obstetrics, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Institute of Biological Psychology, Faculty of Psychology of the Technische Universität Dresden, Dresden, Germany
| | - Tilmann von Soest
- Department of Psychology, PROMENTA Research Center, University of Oslo, Oslo, Norway
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Juliane Junge-Hoffmeister
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany.,Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway
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11
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Metzler YA, Bellingrath S. Psychosocial Hazard Analysis in a Heterogeneous Workforce: Determinants of Work Stress in Blue- and White-Collar Workers of the European Steel Industry. Front Public Health 2017; 5:210. [PMID: 28861410 PMCID: PMC5562717 DOI: 10.3389/fpubh.2017.00210] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 07/28/2017] [Indexed: 11/22/2022] Open
Abstract
The European steel industry’s workforce is highly heterogeneous and consists of various occupational groups, presumably facing different psychosocial stressors. The few existing studies on the subject mainly focused on physical constraints of blue-collar workers, whereas the supposable psychosocial workload received only little research attention. This is remarkable considering the challenges associated with statutory required risk assessment of psychosocial hazards. Valid measures of hazard analysis must account for various stressors and reliably identify them, also between occupational groups. The present study, based on a sample of blue- and white-collar workers (N = 124) from the European steel industry, aims to provide a first insight into psychosocial stressors and strain at work in this rarely researched industrial sector. Furthermore, two well-known theoretical roadmaps in job analysis are examined regarding their utility for risk assessment in heterogeneous workforces: the German standard version of the Copenhagen Psychosocial Questionnaire (COPSOQ) and the short version of the effort–reward imbalance questionnaire. Hierarchical multiple regression analyses revealed that the COPSOQ was better suited to predict various strain indices in the present sample. Especially stressors relating to socioemotional aspects, such as work-privacy conflict, revealed a reasonable impact, indicating the need for comprehensive solutions at the organizational level instead of solutions focusing on single workplaces. To conclude, a broadly diversified and validated approach in psychosocial risk assessment is needed to adequately assess the variety of psychosocial factors at work and in different occupational groups.
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Affiliation(s)
| | - Silja Bellingrath
- Work and Organizational Psychology, University of Duisburg-Essen, Essen, Germany
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12
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Volken T, Wieber F, Rüesch P, Huber M, Crawford RJ. Temporal change to self-rated health in the Swiss population from 1997 to 2012: the roles of age, gender, and education. Public Health 2017; 150:152-165. [PMID: 28802181 DOI: 10.1016/j.puhe.2017.07.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 01/19/2017] [Accepted: 07/07/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Our study aimed to describe the temporal changes in self-rated health status (SRH) from 1997 to 2012 in adults aged 25 to 84 residing in Switzerland, with a view to identifying groups at risk for declining health. STUDY DESIGN Secondary analysis of population-based cross-sectional health surveys. METHODS Data were collected from the cross-sectional, population-based, five-year Swiss Health Survey, from 1997, 2002, 2007 and 2012. A total of 63,861 individuals' data were included. Multilevel mixed-effect logistic regression analysis was employed to estimate the probability of very good and good health within the framework of a hierarchical cross-classified age-period-cohort model (HAPC), adjusting for education level, gender, civil status, smoking status and body mass index. RESULTS Individuals with higher education were substantially more likely than those with primary education to report good SRH (OR = 2.12; 95% CI = 1.93-2.33 for secondary education and OR = 3.79; 95% CI = 3.39-4.23 for tertiary education). The education effect depended on birth cohort and age: higher proportions of good SRH were reported by secondary (8%-17%) and tertiary (10%-22%) compared with primary educated individuals from the 1940 birth cohort onward; the proportion of secondary/tertiary (compared to primary) educated people reporting good SRH increased with age (by 10/11% at 45-50 years and 25/36% at 80-84 years). Gender health equality was achieved by the 1955 (primary educated) and 1960 (secondary educated) birth cohorts, while these women overtook men in reporting good SRH from the 1975 birth cohort onward. Tertiary educated younger women were significantly less likely to report good SRH than men but parity was achieved at around pension age. Similarly, gender inequality in those with primary and secondary education reduced in the younger ages to not be significant at around age 55, with women overtaking men from age 65. CONCLUSIONS Younger birth cohorts with lower education levels appear most vulnerable in terms of their SRH. The education effect cumulatively increases when attaining incrementally higher education levels. While women report lower health than men, gender inequality in SRH has declined and even reversed over time and is substantially linked to differences in educational status. Swiss public health strategies should particularly target the younger adults with only primary school education of both genders; for women, to combat health burdens in their early life, and men, to mitigate issues in their later life.
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Affiliation(s)
- T Volken
- Institue for Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland.
| | - F Wieber
- Institue for Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland; Department of Psychology, University of Konstanz, Konstanz, Germany
| | - P Rüesch
- Institue for Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - M Huber
- Institue for Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - R J Crawford
- Institue for Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland; Faculty of Health Professions, Curtin University, Perth, Australia
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