Health equity through fairer employment and working conditions

Work represents a source of income and social protection, helps determine social status, expands access to social networks, and exposes a person to different types of physical and psycho-social stresses. It is central to many Europeans' lives and has the potential to significantly affect health at the individual and population level.

The University of Dusseldorf is leading three systematic reviews updating knowledge on links between working conditions, social inequalities and unequal health. The first examines the effects of mediation and moderation in prospective studies. The second examines not only the social distribution of occupations included in workplace randomised controlled trials (RCTs), but also the effects of RCTs on health outcomes and whether effect sizes differ between higher and lower socio-economic groups. The third looks at organisational-level interventions to improve working conditions.

Two pieces of data analysis are also being carried out. The first makes use of up-to-date data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and English Longitudinal Study of Ageing (ELSA) to analyse links between socio-economic position (income, occupation, occupational class), work stress, and occupational history in relation to different health statuses. The second analysis, carried out in collaboration with Business in the Community, investigates the results of the Ready For Work back-to-work programme in the UK, looking in particular at different kinds of labour market disadvantage and active labour market practices that help people back or into the employment market.

Overall, Fair employment will provide recommendations to promote health equity through fairer employment and working conditions.

Objectives

• Update knowledge on links between working conditions, social inequalities and health inequalities.
• Critically evaluate effectiveness of workplace interventions.
• Analyse employment and working life histories and their relationships to different health outcomes.
• Analyse the success of a back-to-work scheme in terms of different kinds of social disadvantage and active labour market practice.
• Develop a theoretical model linking national employment and social policies to quality of work and its effects on unequal health.

Past Activities

Research on employment that was carried out within the framework of the DRIVERS project has now been published in the form of several scientific papers:

• Hoven, H.; Ford, D.; Willmot, A.; Hagan, S. & Siegrist, J. (2014): Job Coaching and Success in Gaining and Sustaining Employment Among Homeless People. In: Research on Social Work Practice, 1-7. DOI: 10.1177/1049731514562285
• Hoven, H. & Siegrist, J. (2013): Work characteristics, socio-economic position and health: A systematic review of mediation and moderation effects in prospective studies. In: Occup Environ Med 70, S. 663–669. DOI: 10.1136/oemed-2012-101331.
• Montano, D.; Hoven, H.; Siegrist, J. (2013): A meta-analysis of health effects of randomized controlled worksite interventions: Does social stratification matter? In: Scand J Work Environ Health. DOI: 10.5271/sjweh.3412.
• Montano, D.; Hoven, H.; Siegrist, J. (2014): Effects of organisational-level interventions at work on employees' health: a systematic review. In: BMC Public Health 14, S. 135. DOI: 10.1186/1471-2458-14-135.
• Montano, D. (2014): Chemical and biological work-related risks across occupations in Europe: a review. In: J Occup Med Toxicol 9:28. DOI: 10.1186/1745-6673-9-28.
• Montano, D. (2014): Upper body and lower limbs musculoskeletal symptoms and health inequalities in Europe. An analysis of cross-sectional data. In: MC Musculoskelet Disord. In press.
• Wahrendorf, M. & Siegrist, J. (2014): Proximal and distal determinants of stressful work: framework and analysis of retrospective European data. In: BMC Public Health, 14:849. DOI: 10.1186/1471-2458-14-849.
• Lunau, T.; Wahrendorf, M.; Dragano, N.; Siegrist, J. (2013): Work stress and depressive symptoms in older employees: impact of national labour and social policies. In: BMC Public Health, 13(1):1086. DOI: 10.1186/1471-2458-13-1086.

News

• The Santiago Declaration is a major outcome of “Economic Crisis, Unemployment, Social and Health Effects – and Side Effects – of Action and Inaction”, a conference which took place in Spain in July 2013. Professor Johannes Siegrist of the University of Dusseldorf, partner in the DRIVERS project, was closely involved in its drafting.
• Interview with Prof. Johannes Siegrist: How is globalisation having an impact on health through work? What are the main theoretical models used to study effects of workplace on employee health? How do health inequalities relate to working conditions? What are the opportunities that the DRIVERS project bring to his work?