Lecture 1: Introduction to the course
- Work is an important part of people’s wellbeing including socio-economic position, prestige
and identity
- Work is a major cause of illness and injury, weighing heavily on the health care budgets of
welfare states
- Health effect of work are an area of growing policy attention in an ageing society
What is work?
- Paid and unpaid work/labour (productive versus reproductive/subsistence labour)
- In this course we mainly focus on paid work
- Whether work is paid or unpaid may differ across time and place (e.g. childcare, elderly care)
Jobs
- When we talk about people’s work, we tend to talk about their jobs
- Ahonen et al. (2018) consider jobs to be situated descriptions of employment, that take into
account where and how work is actually performed.
- This is dependent on, for example:
o Employment relationship (self-employment, contract)
o Occupation (teachers, welders, nurses)
o Working conditions (location and hours worked, wages)
o Job characteristics (ergonomic demands)
Health and well-being
- Health and well-being are adjacent concepts
- Well-being is the combination of feeling good and functioning well; the experience of
positive emotions such as happiness and contentment as well as the development of one’s
potential, having some control over one’s life, having a sense of purpose, and experiencing
positive relationships (Huppert, 2009)
- Health is not merely the absence of disease or infirmity but a state of complete physical,
mental and social well-being (World Health Organization)
How does work affect health and wellbeing
Work affects health and wellbeing in complex, reciprocal, heterogeneous ways (Landsbergis et al.,
2018; Ahonen et al., 2018)
- Complex: work affects health/wellbeing differently in different circumstances (and vice versa)
– and work can even be both health-enhancing and health-damaging at the same time
(mineworkers)
- Reciprocal: causal relations run in both directions
- Heterogeneous: work affects the health/wellbeing of different groups of workers differently
(lecture part 3)
What are job rewards / resources
- Work can have a positive impact on wellbeing and health
- We refer to these positive impacts as job rewards, or job resources
- Wellbeing rewards of employment include
o Income, social status
o Identity
o Social networks
- Health rewards of employment include
o Better self-reported physical and mental health
o Psycho-social resources
o Health insurances & benefits
,Job demands or risks
- Work can have a negative impact on wellbeing
and health
- We refer to these negative impacts as job
demands, stressors or risks
- Work related health problems are common
How does work cause physical health risks
- Employment exposes workers to physical and
mental health demands or risks in
heterogeneous or unequal ways
- Different jobs poses different physical demands/risks
o Exposure to hazards (toxic substances, heavy machinery and sharp objects)
o Repetitive overuse ‘wears out’ body (lifting heavy objects)
o Working conditions (long hours, night work)
How does work cause mental health risks
- Some work poses psycho-social demands (stressors), e.g.:
o Stress enhancing forms of work organization (insecurity, scheduling, =>psychosocial
stressors
o Stressful/traumatic interpersonal encounters (e.g toxic work cultures, client/patient
aggression)
o Work pressure
Most common mental health risk factors
Health inequality at work
- Employment is associated with physical and psycho-social resources as well as demands
- These demands and resources are not distributed equally or randomly across the population
- There is a broad consensus on the existence of a ‘social gradient’ in health
- The social gradient implies that ‘health inequalities mirror wider social inequalities’
(Vickerstaff et al., 2008; Ahonen et al, 2018)
Distribution of job risks and rewards
- In this case, health inequalities mirror labour market inequalities
- Labour markets are unequal institutions
, o Social/occupational class theory
o Labour market segmentation; insider/outsider theories (c.f. Kalleberg’s good jobs
bad jobs)
- Paid work or workers is often subdivided into segments:
o Blue vs white collar; manual vs non-manual
o Self-employment vs dependent employment (employee)
o Occupation / occupational class
Occupational health disparities
- Unequal exposure to health risks across jobs
- Occupational health disparities (OHD) framework (Ahonen et al., 2018; Landsbergis et al.,
2018)
o Health disparities related to work result from the exposure to health demands and
resources associated with different jobs (i.e. the package of occupations, working
conditions and job characteristics)
- Jobs expose workers to different risks
- Some jobs expose workers to more risks than others
Unequal selection into ‘good jobs’
- So exposure to health risks differs by type of job
- Access to jobs with greater physical and psycho-social health resources is unequal too
- Therefore, labour market inequalities might be mirrored in health
- People from lower socio-economic backgrounds, lower educated, ethnic minority groups,
migrants and women are less likely to acquire and hold on to ‘good jobs’ in most countries
Labour market vulnerability
- In labour market research, we use the term ‘vulnerable groups’
- There is not one common definition, but the term generally refer to societal groups that
o spend extended periods of time in precarious employment
o are at risk of exclusion from the labour market, at risk of poverty
o that lack the resources to address negative life events or manage risks
- Groups often considered vulnerable in the labour market include: workers with a disability,
NEETs, low educated, migrants, ethnic minorities, single parents, LGBTQIA+
- Intersecting with age and gender
Social selection and social causation
- Factors like educational achievement, ethnicity, migration status, disabilities, and gender are
intertwined with both work and health.
- Theories differ with regard to the direction of causality
- Social selection hypothesis (Mudd et al.,forthcoming):
o People in poor health will be at a disadvantage in the labour market
- Social causation hypothesis (Mudd et al.,forthcoming):
o People in ‘bad’ jobs are exposed to more physical and mental health hazards and
equipped with fewer resources to address sickness and to live healthy lifestyles.’
Take away messages
- The physical and psycho-social demands and resources of jobs are unequally distributed
- Different jobs are associated with different exposure to physical and psycho-social risks,
demands and resources
- A range of factors like gender, age, education, disability, ethnicity and socio-economic
background affect the types of jobs people have access to as well as their health status
- Work is an important part of people’s wellbeing including socio-economic position, prestige
and identity
- Work is a major cause of illness and injury, weighing heavily on the health care budgets of
welfare states
- Health effect of work are an area of growing policy attention in an ageing society
What is work?
- Paid and unpaid work/labour (productive versus reproductive/subsistence labour)
- In this course we mainly focus on paid work
- Whether work is paid or unpaid may differ across time and place (e.g. childcare, elderly care)
Jobs
- When we talk about people’s work, we tend to talk about their jobs
- Ahonen et al. (2018) consider jobs to be situated descriptions of employment, that take into
account where and how work is actually performed.
- This is dependent on, for example:
o Employment relationship (self-employment, contract)
o Occupation (teachers, welders, nurses)
o Working conditions (location and hours worked, wages)
o Job characteristics (ergonomic demands)
Health and well-being
- Health and well-being are adjacent concepts
- Well-being is the combination of feeling good and functioning well; the experience of
positive emotions such as happiness and contentment as well as the development of one’s
potential, having some control over one’s life, having a sense of purpose, and experiencing
positive relationships (Huppert, 2009)
- Health is not merely the absence of disease or infirmity but a state of complete physical,
mental and social well-being (World Health Organization)
How does work affect health and wellbeing
Work affects health and wellbeing in complex, reciprocal, heterogeneous ways (Landsbergis et al.,
2018; Ahonen et al., 2018)
- Complex: work affects health/wellbeing differently in different circumstances (and vice versa)
– and work can even be both health-enhancing and health-damaging at the same time
(mineworkers)
- Reciprocal: causal relations run in both directions
- Heterogeneous: work affects the health/wellbeing of different groups of workers differently
(lecture part 3)
What are job rewards / resources
- Work can have a positive impact on wellbeing and health
- We refer to these positive impacts as job rewards, or job resources
- Wellbeing rewards of employment include
o Income, social status
o Identity
o Social networks
- Health rewards of employment include
o Better self-reported physical and mental health
o Psycho-social resources
o Health insurances & benefits
,Job demands or risks
- Work can have a negative impact on wellbeing
and health
- We refer to these negative impacts as job
demands, stressors or risks
- Work related health problems are common
How does work cause physical health risks
- Employment exposes workers to physical and
mental health demands or risks in
heterogeneous or unequal ways
- Different jobs poses different physical demands/risks
o Exposure to hazards (toxic substances, heavy machinery and sharp objects)
o Repetitive overuse ‘wears out’ body (lifting heavy objects)
o Working conditions (long hours, night work)
How does work cause mental health risks
- Some work poses psycho-social demands (stressors), e.g.:
o Stress enhancing forms of work organization (insecurity, scheduling, =>psychosocial
stressors
o Stressful/traumatic interpersonal encounters (e.g toxic work cultures, client/patient
aggression)
o Work pressure
Most common mental health risk factors
Health inequality at work
- Employment is associated with physical and psycho-social resources as well as demands
- These demands and resources are not distributed equally or randomly across the population
- There is a broad consensus on the existence of a ‘social gradient’ in health
- The social gradient implies that ‘health inequalities mirror wider social inequalities’
(Vickerstaff et al., 2008; Ahonen et al, 2018)
Distribution of job risks and rewards
- In this case, health inequalities mirror labour market inequalities
- Labour markets are unequal institutions
, o Social/occupational class theory
o Labour market segmentation; insider/outsider theories (c.f. Kalleberg’s good jobs
bad jobs)
- Paid work or workers is often subdivided into segments:
o Blue vs white collar; manual vs non-manual
o Self-employment vs dependent employment (employee)
o Occupation / occupational class
Occupational health disparities
- Unequal exposure to health risks across jobs
- Occupational health disparities (OHD) framework (Ahonen et al., 2018; Landsbergis et al.,
2018)
o Health disparities related to work result from the exposure to health demands and
resources associated with different jobs (i.e. the package of occupations, working
conditions and job characteristics)
- Jobs expose workers to different risks
- Some jobs expose workers to more risks than others
Unequal selection into ‘good jobs’
- So exposure to health risks differs by type of job
- Access to jobs with greater physical and psycho-social health resources is unequal too
- Therefore, labour market inequalities might be mirrored in health
- People from lower socio-economic backgrounds, lower educated, ethnic minority groups,
migrants and women are less likely to acquire and hold on to ‘good jobs’ in most countries
Labour market vulnerability
- In labour market research, we use the term ‘vulnerable groups’
- There is not one common definition, but the term generally refer to societal groups that
o spend extended periods of time in precarious employment
o are at risk of exclusion from the labour market, at risk of poverty
o that lack the resources to address negative life events or manage risks
- Groups often considered vulnerable in the labour market include: workers with a disability,
NEETs, low educated, migrants, ethnic minorities, single parents, LGBTQIA+
- Intersecting with age and gender
Social selection and social causation
- Factors like educational achievement, ethnicity, migration status, disabilities, and gender are
intertwined with both work and health.
- Theories differ with regard to the direction of causality
- Social selection hypothesis (Mudd et al.,forthcoming):
o People in poor health will be at a disadvantage in the labour market
- Social causation hypothesis (Mudd et al.,forthcoming):
o People in ‘bad’ jobs are exposed to more physical and mental health hazards and
equipped with fewer resources to address sickness and to live healthy lifestyles.’
Take away messages
- The physical and psycho-social demands and resources of jobs are unequally distributed
- Different jobs are associated with different exposure to physical and psycho-social risks,
demands and resources
- A range of factors like gender, age, education, disability, ethnicity and socio-economic
background affect the types of jobs people have access to as well as their health status
