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theoretical Model provisions: unemployment benefits (based upon previous earnings), unemployment assistance, and guaranteed minimum schemes. Other schemes include disability, employment injury and occupational disease (workers' compensation), maternity leave, and pension benefits. The various welfare state schemes across the world often rely on a unique combination of these same practices. Although we acknowledge the difficulties inherent in establishing an overall framework that fits the entire world, its broad scope allows sufficient generality to be applied at different levels of aggregation (national, regional, local). This theoretical macro framework, its concepts and indicators are contingent upon specific historical contexts and processes (i.e., informal work may mean a situation of precariousness in wealthy countries but a situation of extreme poverty in poor countries). 4.2. MICRO FRAMEWORK The micro framework in Figure 3 helps trace the links between employment and working conditions and health inequalities through three different pathways: behavioural, psychosocial, and physiopathological. At the level of work organisation, potential exposures, hazards and risk factors are classified into five main categories: physical, chemical, biological, ergonomic, and psychosocial. They include factors such as exposure to physical or chemical hazards, repetitive movements, work intensification, hard physical labour, shift-work, or lack of control. To these factors we also add work-related injuries (i.e., occupational "accidents"). Figure 3. Micro-theoretical framework of employment and working conditions and health inequalities. EMPLOYMENT Employment Conditions - Full-time Permanent Employment - Unemployment - Precarious Employment - Informal Employment - Child Labour - Slavery and Bonded Labour WORK ORGANISATION Working conditions Exposures, Hazards and Risk Factors: - Physical - Chemical - Biological - Ergonomic - Psychosocial Material Deprivation and Economic Inequalities Health-related Behaviours Health-related Outcomes Physio-pathological Changes Health Inequalities Health Systems Social and Family Networks ModEl oF dYnAMiC liFE-CoursE intErACtions Country / regional / locally influenced by social class, gender, ethnicity, age and migrant status source: prepared by the authors 33
EMploYMEnt, work, And hEAlth inEquAlitiEs - a global perspective in the Chureca dump in Managua (nicaragua), boys and girls work in worse conditions than adults. source: antonio rosa (2005) While each risk factor may lead to different health outcomes through various mechanisms, some main points need to be emphasised here. First, axes such as social class, gender, and ethnicity/race are key relational mechanisms that explain why workers, and often their families, are exposed to multiple risks. For example, there is a growing body of scientific evidence showing that workers are more exposed to physical and chemical hazards compared to owners or managers. Second, three of the key specific social mechanisms underlying class, gender, and ethnicity/race are exploitation, domination, and discrimination (Muntaner, 1999; Muntaner, Benach, Hadden, Gimeno, & Benavides, 2006; Krieger, 2000). And third, those cross-cutting axes (i.e., social class, gender, and ethnicity/race but also other related aspects such as age, migrant status, or geographical location) may be linked to multiple disease outcomes through different risk-factor mechanisms. These key axes generating work-related health inequalities can influence disease even though the profile of risk factors may vary dramatically (Link & Phelan, 1996). Material deprivation and economic inequalities (e.g., nutrition, poverty, housing, income, etc.), exposures which are closely related to employment conditions, may also have an important effect on chronic diseases and mental health via several life-style behaviours, physio-pathological changes, and health-related outcomes. For example, the length of time children have been working may have an effect on growth and academic performance, probably caused by a lack of adequate nutrition (Hawamdeh & Spencer, 2003). In addition to the key role played by these material factors, proponents of psychosocial theories have emphasised the central importance played by one's position in a hierarchy, that is, where one stands in relation to others. There are two models that analyse the role of the psychosocial work environment in explaining health inequalities. The first is the popular demand-control model (Karasek, 1979) based on the balance between quantitative demand and low control (i.e., limited decision latitude and lack of skill discretion). The second is the effort-reward imbalance model, which claims that high efforts spent at work that are not met by adequate rewards (money, esteem, promotion prospects, job security) elicit recurrent stressful experiences (Siegrist & Theorell, 2006). Nevertheless, although discussion of material versus psychosocial factors may be important for research purposes as well as for the type of interventions to be considered, it has been argued that the dichotomy between both theories has been overblown (Muntaner, 2004; Macleod & Smith, 2003). The 34
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EmploymEnt, Work and HEaltH InEqual
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CORE GROUP* Carlos H. Alvarado, Fra
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Policies and Interventions 9 "The k
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policies and interventions to reduc
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policies and interventions case stu
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policies and interventions for expo
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policies and interventions Under ne
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policies and interventions his acco
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policies and interventions 9.3. eMp
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policies and interventions who actu
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policies and interventions Figure 2
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policies and interventions power re
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policies and interventions free pro
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policies and interventions employme
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policies and interventions Pública
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policies and interventions conditio
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policies and interventions factors
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policies and interventions informat
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policies and interventions financin
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policies and interventions better i
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policies and interventions referenc
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policies and interventions Table 14
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policies and interventions urban ar
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policies and interventions 9.6. ass
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Epilogue: the economic crisis 10
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epilogue: the econoMic crisis this
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epilogue: the econoMic crisis group
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epilogue: the econoMic crisis Case
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epilogue: the econoMic crisis group
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epilogue: the econoMic crisis feedi
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Conclusions & recommendations 11 "I
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Appendix
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AppeNdIx recommendation no. 190 and
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AppeNdIx employment conditions. emp
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AppeNdIx Forced labour. Although th
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AppeNdIx Job discrimination. this t
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AppeNdIx in: muntaner, c., Benach,
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AppeNdIx in: Bartley, m., & Ferrie,
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AppeNdIx work intensification. work
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AppeNdIx Bank's Atlas method (adjus
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AppeNdIx table a2. descriptive stat
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AppeNdIx table a3. labour market fa
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AppeNdIx CorE sEmi-pEriphEry pEriph
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AppeNdIx Country clusters table A5
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AppeNdIx semi-peripheral countries
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AppeNdIx Figure a6. Health indicato
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RefeRences RefeRences 1. IntroductI
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arrangements and precariousness in
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International Labour Organization.
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Benach (Eds.), Desigualtats en salu
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Instituto Nacional de Estadística
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desde América Latina y el Caribe.
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Woldehanna, T., Guta, F., & Ferede,
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unemployment Chan, W. S., Yip, P. S
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International Labour Organization.
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Clarke, S., Sloane, D., & Aiken, L.
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among residents in the Trent region
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Sales, E. C., & Santana, V. S. (200
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Parent-Thirion, A., Fernandez, M. E
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Unemployment and mental health: Und
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Tytherleigh, M. Y., Jacobs, P. A.,
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Chilcoat, E. (2008). Pinkie promise
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Africa. Perspective of Global Devel
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freight transport and distribution
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Índex LIST OF FIGURES 2. Fair empl
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Table A5. Country clusters by labou
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Case study 43. Sexual orientation,
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acronyms and abrevIatures AIDS - Ac
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autHors and contrIbutors CORE GROUP
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Maria da Graça Luderitz Hoefel. Ho
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Maria da Graça Luderitz Hoefel. Ho
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INSTITUTIONS AND ASSOCIATIONS THAT
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