Employmentweb_low

eMployMent relations and health inequalities: pathways and MechanisMs
selected scientific findings
Whitehall II article describing employment grade inequalities in health and their determinants
the whitehall study of british civil servants, begun in 1967, showed a steep inverse association between social
class (as assessed by grade of employment) and mortality from a wide range of diseases. between 1985 and 1988, we
investigated the degree and causes of the social gradient in morbidity in a new cohort of 10,314 civil servants (6900 men,
3414 women) aged 35-55 (the whitehall ii study). participants were asked to complete a self-administered questionnaire
and attend a screening examination. in the 20 years separating the two studies there has been no decrease in social
class-based differences in morbidity: we found an inverse association between employment grade and prevalence of
angina, electrocardiogram evidence of ischemia, and symptoms of chronic bronchitis. self-perceived health status and
symptoms were worse in subjects in lower status jobs. there were clear employment-grade differences in health-risk
behaviours including smoking, diet and exercise, as well as in economic circumstances, possible effects of early-life
environment as reflected by height, social circumstances at work (e.g., monotonous work characterised by low control
and low satisfaction) and in social supports. More attention should be paid to the social environments, job design and
consequences of income inequality.
Source
Marmot, M. g., smith, g. d., stansfeld, s., patel, c., north, F., head, J., et al. (1991). health inequalities among british
civil servants: the whitehall ii study. The Lancet, 337(8754), 1387-1393.
Class and gender inequalities in wages and working conditions for full-time employees
work shapes health inequalities via several pathways, including hazards in the workplace as well as economic
resources derived from work.
income has been repeatedly associated with measures of health and disease. a recent analysis of the 1980-83 and
1991 editions of the national living conditions survey in the netherlands shows a clear and steep gradient in mean
annual net income by occupational social class among full-time workers. within occupational groups, a gender pay gap
also exists, with women being paid less on average than men. For instance, in 1991, among men, higher employees had
a mean annual income of 22,034 euros; intermediate employees, 17,080; lower employees, 14,637; and lowest rank
employees, 12,781. among women, mean incomes for those categories were 16,914 euros, 13,670 euros, 11,567 euros,
and 10,490 euros, respectively. a european review on the gender pay gap finds inequality in all the countries studied,
with women’s earnings ranging between 64 per cent and 86 per cent of men’s, with a generally slow trend towards
narrowing the gap.
physical and psychosocial risks at work are also unequally distributed according to socioeconomic status. in the
2000 edition of the cited dutch survey, labourers clearly had the worst physical working conditions, measured with a
scale integrating several hazards. For these workers, scores were 4.21 for men and 2.56 for women, compared to 1.32
and 1.29 among lower employees or 0.86 and 0.50 for higher employees. the gradient in physical exposures within
employees is present but narrow. on the other hand, it is steeper for a psychosocial risk such as skill discretion. Figures
for europe are available for different occupational groupings: legislators and managers, professionals, technicians,
clerks, service and sales workers, agricultural workers, craft-related trade workers, plant and machine operators,
elementary occupations and armed forces. professionals have the lowest prevalence of monotonous tasks and one of
the lowest of physical and ergonomic hazards, as well as the highest frequency of “learning new things”. on the other
extreme lie those working in elementary occupations (in terms of psychosocial risks); craft workers (in terms of
physical risk such as noise and dust); and agricultural workers (in terms of painful positions and heavy loads, repetitive
movements and continuous high speed).
Sources
houtman, i., & evers, M. (2007). the netherlands. in i. lundberg, t. hemmingsson, & c. hogstedt (eds.), Work and Social
Inequalities in Health in Europe. brussels: p.i.e. peter lang.
paoli. p., & Merllié, d. (2001). Third European survey on working conditions 2000. luxembourg: office for official publications
of the european communities.
soumeli, e., & nergaard, K. (2002). Gender pay equity in Europe. dublin: european Foundation for the improvement of living
and working conditions.
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