Occupational Inequalities Research Articles

Occupational and educational inequalities in exit from employment at older ages: evidence from seven prospective cohorts

ObjectivesPast studies have identified socioeconomic inequalities in the timing and route of labour market exit at older ages. However, few studies have compared these trends cross-nationally and existing evidence focuses...

Role of working conditions in the explanation of occupational inequalities in work injury: findings from the national French SUMER survey

BackgroundSocial inequalities in work injury have been observed but explanations are still missing. The objectives of this study were to evaluate the contribution of working conditions in the explanation of social inequalities in work injury in a national representative sample of employees.MethodsThe study was based on the cross-sectional sample of the national French survey SUMER 2010 including 46,962 employees, 26,883 men and 20,079 women. The number of work injuries within the last 12 months was studied as the outcome. Occupation was used as a marker of social position. Psychosocial work factors included various variables related to the classical job strain model, psychological demands, decision latitude, social support, and other understudied variables related to reward, job insecurity, job promotion, esteem, working time and hours and workplace violence. Occupational exposures of chemical, biological, physical and biomechanical nature were also studied. Weighted age-adjusted Poisson regression analyses were performed.ResultsOccupational gradients were observed in the exposure of most psychosocial work factors and occupational exposures. Strong occupational differences in work injury were found, blue-collar workers being more likely to have work injury. Chemical, biological, physical and biomechanical exposures contributed to explain the occupational differences in work injury substantially. Noise, thermic constraints, manual materials handling, postural/articular constraints and vibrations had significant contributions. Psychosocial work factors also contributed to explain the differences especially among women.ConclusionPrevention policies oriented toward chemical, biological, physical, biomechanical and psychosocial work exposures may contribute to reduce the magnitude of occupational differences in work injury.

The ‘healthy worker effect’: Do healthy people climb the occupational ladder?

The association between occupational status and health has been taken to reveal the presence of occupational health inequalities. However, that interpretation assumes no influence of health status in climbing the occupational ladder. This paper documents evidence of non-negligible returns to occupation status on health (which we refer as ‘healthy worker effect’). We use a unique empirical strategy that addresses the problem of reverse causality. That is, an instrumental variable strategy using the variation in average health in the migrant’s country of origin, a health measure plausibly not determined by the migrant’s occupational status. Our findings suggest that health status exerts significant effects on occupational status in several dimensions; including having a supervising role, worker autonomy, and worker influence. The effect size of health is larger than that of an upper secondary education.

Stillbirth at a Nigerian Tertiary Hospital

Background: Despite improvements in antenatal and intrapartum care, stillbirth still remains an important, largely understudied and pregnant problem in obstetrics. Most of the stillbirths occur in the developing world and the majority of stillbirths are preventable. Objective: To determine the stillbirth rate, the identifiable risk factors and sociodemographic factors associated with stillbirths. Materials and Methods: This was a retrospective review of all deliveries conducted at UATH over a five-year period spanning from the January 2012 to December 2016. In this study, stillbirths were considered as foetal death at or after 28 weeks of gestation or a birth weight of 1000 g or more. The folders of cases that met the definition of stillbirth within the study period were retrieved and analyzed for sociodemographic factors, type of stillbirth, fetomaternal determinants of stillbirths and presumptive/identifiable risk factors for the stillbirth. Results: There were a total of 5714 deliveries within the period under review, of which 288 resulted in stillbirths giving an institutional stillbirth rate of 50.4/1000 deliveries. Out of the 288 stillbirths, 136 (47.2%) were fresh stillbirths while 152 (52.8%) were macerated. Macerated stillbirth (152, 52.8%) was slightly predominant, with obstructed labour 94 (32.6%) being responsible for most of the stillbirths. Most of the stillbirths were preterm (183, 63.5%). There were 6 congenitally malformed stillbirth foetuses and no autopsy was carried out on any of the 288 stillborn. However, majority of the parturients who had stillbirth were unemployed (137, 47.6%) and uneducated (110, 38.2%). Conclusion: The stillbirth rate within the study period appears. Complications of labour seem to be the leading risk factor for stillbirth in this study. Low socioeconomic status underscores the need to reduce factors related to social, educational, occupational and healthy inequalities in the developing world.

Site-specific cancer mortality inequalities by employment and occupational groups: a cohort study among Belgian adults, 2001–2011

ObjectiveThis study probes into site-specific cancer mortality inequalities by employment and occupational group among Belgians, adjusted for other indicators of socioeconomic (SE) position.DesignThis cohort study is based on record linkage...

Occupational class inequalities in disability retirement after hospitalisation.

This study aimed to investigate whether hospitalisation is associated with increased risk of disability retirement differently across four occupational classes. 170,510 employees of the City of Helsinki, Finland were followed from 1990 to 2013 using national registers for hospitalisations and disability retirement. Increases in the risk of disability retirement after hospitalisation for any cause, cardiovascular diseases, musculoskeletal disorders, mental disorders, malignant neoplasms, respiratory diseases and injuries were assessed across four occupational classes: professional, semi-professional, routine non-manual and manual, using competing risks models. In general, hospitalisation showed a slightly more increased risk of disability retirement in the lower ranking occupational classes. Hospitalisation among women for mental disorders showed a more increased risk in the professional class (hazard ratio 14.73, 95% confidence interval 12.67 to 17.12) compared to the routine manual class (hazard ratio 7.27, 95% confidence interval 6.60 to 8.02). Occupational class differences were similar for men and women. The risk of disability retirement among women increased most in the routine non-manual class after hospitalisation for musculoskeletal disorders and injuries, and most in the professional class after hospitalisation for cardiovascular diseases. The corresponding risks among men increased most in the two lowest ranking classes after hospitalisation for injuries. Ill-health as measured by hospitalisation affected disability retirement in four occupational classes differently, and the effects also varied by the diagnostic group of hospitalisation. Interventions that tackle work disability should consider the impact of ill-health on functioning while taking into account working conditions in each occupational class.

Time trends in absolute and relative socioeconomic inequalities in leisure time physical inactivity in northern Sweden.

The aim was to investigate the time trends in educational, occupational, and income-related inequalities in leisure time physical inactivity in 2006, 2010, and 2014 in northern Swedish women and men. This study was based on data obtained from the repeated cross-sectional Health on Equal Terms survey of 2006, 2010, and 2014. The analytical sample consisted of 20,667 (2006), 31,787 (2010), and 21,613 (2014) individuals, aged 16-84. Logistic regressions were used to model the probability of physical inactivity given a set of explanatory variables. Slope index of inequality (SII) and relative index of inequality (RII) were used as summary measures of the social gradient in physical inactivity. The linear trend in inequalities and difference between gender and years were estimated by interaction analyses. The year 2010 displayed the highest physical inactivity inequalities for all socioeconomic position indicators, but educational and occupational inequalities decreased in 2014. However, significant positive linear trends were found in absolute and relative income inequalities. Moreover, women had significantly higher RII of education in physical inactivity in 2014 and significantly higher SII and RII of income in physical inactivity in 2010, than did men in the same years. The recent reduction in educational and occupational inequalities following the high inequalities around the time of the great recession in 2010 suggests that the current policies might be fairly effective. However, to eventually alleviate inequities in physical inactivity, the focus of the researchers and policymakers should be directed toward the widening trends of income inequalities in physical inactivity.

Working conditions in the explanation of occupational inequalities in sickness absence in the French SUMER study.

Explanations of social inequalities in sickness absence are lacking in the literature. Our objectives were to evaluate the contribution of various occupational exposures in explaining these inequalities in a national representative sample of employees. The study was based on the cross-sectional sample of the SUMER 2010 survey that included 46 962 employees, 26 883 men and 20 079 women. Both sickness absence spells and days within the last 12 months, as health indicators, were studied. Occupation was used as a marker of social position. The study included both psychosocial work factors (variables related to the classical job strain model, psychological demands, decision latitude, social support and understudied variables related to reward, job insecurity, job promotion, esteem, working time/hours and workplace violence) and occupational exposures of chemical, biological, physical and biomechanical nature. Weighted age-adjusted Poisson and negative binomial regression analyses were performed. Strong occupational differences were found for sickness absence spells and days and for exposure to most work factors. Psychosocial work factors contributed to explain occupational differences in sickness absence spells, and the contributing factors were: decision latitude, social support, reward, shift work and workplace violence. Physical exposure, particularly noise, and biomechanical exposure were also found to be contributing factors. Almost no work factor was found to contribute to occupational differences in sickness absence days. Preventive measures at the workplace oriented towards low-skilled occupational groups and both psychosocial work factors and other occupational exposures may be beneficial to reduce sickness absence spells and occupational differences in this outcome.

Inequalities in obesity in Portugal: regional and gender differences.

Obesity levels vary considerably according to geographical region and socio-economic status. We evaluated the prevalence of obesity by education and occupational position across seven Portuguese regions. Relative and absolute inequalities in obesity were also assessed. Data was drawn from the Portuguese Health Survey 2005/6 (26 674 adults, 46.6% women). Education was categorized as ≤4, 5-11 and ≥12 complete years of education. Occupational position was grouped as upper white collar, lower white collar and blue collar. The Relative Index of Inequality (RII) and the Slope Index of Inequality (SII) were used to quantify relative and absolute inequalities in obesity, respectively. In women, prevalence of obesity ranged between 10.0% (Algarve) and 20.3% (Azores); in men, it ranged between 13.3% (Algarve) and 16.4% (Lisbon). In women, the educational RII (95% confidence interval) ranged between 2.4 (1.1 to 5.1) in the Centre and 6.6 (3.0 to 14.2) in Alentejo, and the SII (95% CI) between 9.7 (-1.3 to 20.7) and 33.0 (26.0 to 40.0), respectively. In men, the RII ranged between 0.8 (0.4 to 1.5) in Madeira and 1.9 (1.0 to 4.5) in the Centre, and the SII between -8.3 (-19.0 to 2.5) and 9.5 (-0.1 to 19.1), respectively. Occupational RIIs were similar to those for education, although somewhat lower. In Portugal, large educational and occupational inequalities in obesity are observed, but they vary considerably by region and are larger among women than men.

Trends in occupational disparities for exposure to carcinogenic, mutagenic and reprotoxic chemicals in France 2003-10.

To explore trends in social and occupational inequalities in terms of exposure to carcinogenic, mutagenic and reprotoxic chemicals (CMR) for French employees. Our study assessed data from the French national cross-sectional survey of occupational hazards (SUMER) that was conducted in 2003 and 2010. We included all of the 27 CMR agents that were classified by the International Agency for Research on Cancer or European Union regulations as being known or presumed to have CMR potential in humans. Trends in prevalence and degree of exposure were examined using multilevel logistic regression analysis. The number of employees exposed to CMR agents decreased by 17.5% between 2003 and 2010. The only CMR entities for which exposure rates increased are not considered to be proven CMRs according to the European Union regulations. With the exception of apprentices, there was an overall decrease in exposure prevalence for all employees. This decrease occurred, however, to different extents. The decrease in the risk of exposure to CMR agents was much greater for those on permanent contracts, managers, and in enterprises with more than 500 employees. Nonetheless, in situations where there was potential for exposure, companies with fewer than 10 employees were in fact able to decrease the degree of risk more than the others. Our results confirm the relevance of reinforcing regulatory restrictions for CMR products, while also indicating that monitoring of trends in disparities will allow public health policy makers to better evaluate progress made toward reducing disparities that affect vulnerable populations.

Health Inequalities Among Korean Employees.

BackgroundSocial status might be a determinant of occupational health inequalities. This study analyzed the effects of social status on both work environments and health outcomes.MethodsThe study sample consisted of 27,598 wage employees aged 15 years and older from among the Korean Working Condition Survey participants in 2011. Work environments included atypical work, physical risks, ergonomic risks, work demands, work autonomy, social supports, and job rewards. Health outcomes comprised general health, health and safety at risk because of work, the World Health Organization-5 Well-being Index, work-related musculoskeletal disease, and work-related injury. Multivariable logistic-regression models were used to identify the associations between social status and work environments and health outcomes.ResultsEmployees in the demographically vulnerable group had lower occupational status compared with their counterparts. Low social status was largely related to adverse work environments. Especially, precarious employment and manual labor occupation were associated with both adverse work environments and poor health outcomes.ConclusionPrecarious and manual workers should take precedence in occupational health equity policies and interventions. Their cumulative vulnerability, which is connected to demographics, occupational status, adverse work environments, or poor health outcomes, can be improved through a multilevel approach such as labor market, organizations, and individual goals.

Occupational inequalities in self-rated health and non-communicable diseases in different regions of Europe: findings from the European Social Survey (2014) special module on the social determinants of health.

Socioeconomic inequalities in the prevalence of non-communicable diseases (NCDs) are evident across European populations. Several previous studies have addressed the question of whether occupational inequalities in health differ across European regions. It is uncertain however, the degree to which occupational inequalities in NCDs are similar or dissimilar across different European regions. Using 2014 European Social Survey data from 20 countries, this article examines occupational inequalities in poor self-rated health (SRH) and 14 self-reported NCDs separately for women and men, by European region: heart/circulatory problems, high blood pressure, back pain, arm/hand pain, foot/leg pain, allergies, breathing problems, stomach/digestion problems, skin conditions, diabetes, severe headaches, cancer, obesity and depression. Age-controlled adjusted risk ratios were calculated and separately compared a working class and intermediate occupational group with a salariat group. Working class Europeans appear to have the highest risk of reporting poor SRH and a number of NCDs. We find inequalities in some NCDS to be the largest in the Northern region, suggesting further evidence of a Nordic paradox. Like some previous work, we did not find larger inequalities in poor SRH in the Central/East region. However, we did find the largest inequalities in this region for some NCDs. Our results do not align completely with previous work which finds smaller health inequalities in Southern Europe. This work provides a first look at occupational inequalities across a range of NCDs for European men and women by region. Future work is needed to identify the underlying determinants behind regional differences.

Variations in mesothelioma mortality rates among migrants to Australia and Australian-born

ABSTRACTBackground: Australia’s use and consumption of asbestos occurred at the same time as its immigration boom. Our objective was to investigate mesothelioma death rates among migrants and Australian-born between 1981 and 2012.Methods: Australian national mesothelioma deaths from 1981 to 2002 and 2006 to 2012 together with national censuses from 1981 to 2011 were extracted and combined. Directly standardised rates and negative binomial regression were applied examining differences in mesothelioma death rates with regard to country of birth.Results: Migrants from the UK and Ireland, Italy and Germany had significantly higher mesothelioma death rates than Australian-born; lower rates were observed among migrants from other countries.Conclusions: Our findings suggest there may have been differences in occupational health and safety between foreign and Australian-born. Because of changes in the demographics of migrants to Australia since the 1970s and changes in occupational circumstances over time, further comparisons of occupational-related health outcomes between foreign and Australian-born could identify potential occupational inequalities that may still exist today.

Mill, Rawls and Cohen on Incentives and Occupational Freedom

G. A. Cohen's critique of Rawls's defence of economic incentives echoes some of J. S. Mill's insights on the subject. Some of Cohen's arguments, however, clash not only with those of Rawls but also with each other as well as with Mill's. A similar charge, however, may be made against Rawls. This article has conciliatory ambitions. It suggests reconciling each author with himself, as well as with each other, by focusing onthe worthof liberty. It stresses the importance of non-pecuniary occupational inequalities and proposes various measures to enhance the worth of the occupational freedom of those with fewer options.

Occupational and educational inequalities in health-related exits from employment at older ages: evidence from 6 prospective cohorts

Occupational and educational inequalities in health-related exits from employment at older ages: evidence from 6 prospective cohorts

Occupational and educational inequalities in health-related exits from employment at older ages

Occupational and educational inequalities in health-related exits from employment at older ages

Which Clouds Have Silver Linings? Fixed-Term Employment, Psychological Distress, and Occupational Position in Poland

In recent years, many studies have attempted to assess the relationship between contractual status and a range of well-being outcomes, including self-reported health status or psychological distress. These studies have generally failed to establish a conclusive, straightforward link between working on a fixed-term contract and subjective quality of life. In light of these results, further attention needs to be paid to the heterogeneity of temporary jobs in terms of working conditions and the career prospects they offer. This article examines the occupational differences in the effects of fixed-term employment on the psychological condition of workers, bringing together two separate lines of research: on the psychological consequences of fixed-term employment and the structural and institutional determinants of the wage effects and career consequences of temporary jobs. The analyses are based on data from the past two waves of the Polish Panel Survey POLPAN, 2008 and 2013. POLPAN is the only Polish survey that includes detailed information on the type of employment contract, as well as multidimensional indicators of mental health (components of the Nottingham Health Profile). The mixed empirical results give rise to important insights into the complex links between employment flexibility and occupational inequalities on the Polish labor market.

Income inequalities for recently graduated French workers: a multilevel modeling approach

This paper presents a simultaneous study of the impact of gender, occupational and localization inequalities on the earnings of higher education graduates. The framework draws on both individual level (i.e., pertaining to the individual elements of groups) and aggregate level (i.e., pertaining to the group as a whole) data under a single specification. To take into account the selection process for employment, our multilevel model uses the Heckman two-step procedure. Occupational Groups (OG) are found to capture around 40 % of the wage heterogeneity, whereas Employment Area (EA) nests capture less than 10 %. Higher wages are offered to young workers in (1) OG dominated by seniors and (2) OG dominated by men. These group characteristics also influence gender inequalities: there is a higher wage penalty for women in (1) OG dominated by men and (2) OG dominated by senior workers. In contrast to gender inequality, immigrant inequalities manifest closer links to EA.

Misalignment of Career and Educational Aspirations in Middle School: Differences across Race, Ethnicity, and Socioeconomic Status.

Misalignment of educational and career goals (i.e., educational aspirations expressed are inadequate for attaining one’s desired occupation) is associated with lower educational attainment and a lack of college readiness, and may contribute to persistent educational and employment disparities. Drawing on data from 249 sixth graders in low-income schools, this research examines misalignment between educational and career aspirations across racial and ethnic and socioeconomic groups. Findings indicate that students in low-income schools aspire to middle and upper middle class careers, but sometimes lack an understanding of the educational degrees required to achieve their goals. Latinos are significantly more likely than other groups to report misaligned aspirations, as are students in the free and reduced lunch program and those without a college-educated parent. Consequently, early gaps in misaligned career and educational goals for disadvantaged students may set them on a trajectory that perpetuates educational and occupational inequalities in this population. We discuss the programmatic implications of these findings in light of the elevated college and career planning needs of students traditionally underrepresented in higher education.

An old model of social class? Job characteristics and the NS-SEC schema

This article explores the relationship between the job characteristics underlying the Goldthorpe model of social class (work monitoring difficulty and human asset specificity) and those underlying theories of technological change (routine and analytical tasks) highlighted as key drivers for growing inequality. Analysis of the 2012 British Skills and Employment Survey demonstrates monitoring difficulty and asset specificity predict National Statistics Socio-Economic Classification (NS-SEC) membership and employment relations in ways expected by the Goldthorpe model, but the role of asset specificity is partially confounded by analytical tasks. It concludes that while the Goldthorpe model continues to provide a useful descriptive tool of inequality-producing processes and employment relations in the labour market, examining underlying job characteristics directly is a promising avenue for future research in understanding over time dynamics in the evolution of occupational inequalities.