Contemporary Occupational Health Psychology, Volume 3

Global Perspectives on Research and Practice

Stavroula Leka, Robert R. Sinclair, Stavroula Leka, Robert R. Sinclair

• Éditeur: Wiley-Blackwell
• Année: 2014
• ISBN:
  9781118713891
• Édition: 1
• Sujet: Psychologie
• Sous-sujet: Industrie- & Organisationspsychologie

The third volume in an acclaimed biennial series showcasing the latest global thinking, research, and practice in the rapidly-evolving field of occupational health psychology.

• Published in partnership with the European Academy for Occupational Health Psychology (EAOHP) and the Society for Occupational Health Psychology (SOHP)
• Presents state-of-the-art research along with its implications for real-world practice, with contributions from Europe, North America, Asia, and Australia
• Topics covered include psychological health during organizational restructuring, immigrant occupational health and well-being, increasing the effectiveness of safety training programs, and the WHO Healthy Workplaces Model
• Contributors include Fred Leong, Hans de Witte, Eva Demerouti and Sir Michael Marmot

1
Social Determinants of Health and the Working-Age Population: Global Challenges and Priorities for Action

Angela Donkin, Matilda Allen, Jessica Allen, Ruth Bell, and Michael Marmot

UCL Institute of Health Equity, UK

Introduction

Health inequalities and the importance of the social determinants of health

In 2008, the Commission on Social Determinants of Health (Commission on the Social Determinants of Health, 2008) reported on global health inequalities and priorities for action. Since then, two reviews have been written on health inequalities: one within the UK (The Marmot Review Team, 2010) and one for the WHO European region (The Institute of Health Equity, 2013).

These reports describe the avoidable inequalities in health and length of life both within and between countries. For example, there is a difference of 17 years in life expectancy within the London Borough of Westminster (The Marmot Review Team, 2010) and also a difference of 17 years in male life expectancy between the richest and poorest countries in Europe (The Institute of Health Equity, 2013). Globally, there is a difference of 36 years between the life expectancy of Sierra Leone (47 years) and Japan (83 years) (World Health Organization, 2013). In many countries, there are even larger differences in “disability-free” or “healthy” life expectancy – the number of years a person can expect to live in full health.

These differences occur because people with a higher socioeconomic position live longer and spend more of their life in good health. The key underlying theme to all the reports is that inequalities in health and mortality are not simply a result of genetic variation, or access to health care, important as these are, but that health inequities arise from the conditions in which people are born, grow, live, work, and age and inequities in power, money, and resources that give rise to these conditions of daily life. In order to reduce health inequalities, the evidence-based reports make a number of specific evidence-based recommendations, conceptualized around the life course (see Figure 1.1), which group around the following themes:

• Giving every child the best start in life
• Ensuring good education and enabling all to take control over their lives
• Access to employment and “good jobs”
• Ensuring a sufficient income for healthy living
• Ensuring access to green and sustainable environments
• Placing more focus on ill health prevention
• The need to act across the whole gradient (proportionate universalism)
• A focus on human rights and equality issues

Figure 1.1 A Life Course Approach to Tackling Inequalities in Health.

Source: © The Institute of Health Equity, 2013.

Working age in context

Given the emphasis of this book, we are going to focus on inequalities in the working-age population and the role that work can play, both as a positive and negative social determinant of health. However, it is important to note that social determinants start to influence outcomes from the prenatal period, through childhood, and into education. By the time people are of working age, they may already be unable to make the most of the opportunities available given the cumulative disadvantage that may have built up over their lifetime. Action to give children the best start in life and to ensure good education for all will improve the economic prospects of the working-age population and help build a stronger foundation for mental and physical health. These aspects are covered in more depth in the full reviews (Commission on the Social Determinants of Health, 2008; The Institute of Health Equity, 2013; The Marmot Review Team, 2010) and in a specific piece of work on children’s outcomes (Pordes-Bowers, Strelitz, Allen & Donkin, 2012).

Actions and policies focused on the working-age population will also have an effect later on in the life course. As workers retire, the health impacts of their working life, and the level of economic security which they have been able to achieve, will influence their lives in older age. Additionally, increases in longevity and rising pension ages mean there are more people of older age within the workforce and, therefore, more people in the workforce with limiting illnesses and disabilities. It must be ensured that these workers have access to the infrastructure they need to remain in, or be able to return to, work (The Institute of Health Equity, 2013).

The social gradient

In every country, health-adverse material and psychosocial conditions of work and employment are unequally distributed. Those with a higher level of education, income, and a better labor market or occupational position are more likely to be employed and more likely to have better work and employment conditions, which will, in turn, result in better physical and mental health outcomes (Siegrist, Rosskam & Leka, 2012). The following evidence on the effects of employment on health often shows a graded distribution of harm across society. Similarly, there are differences between countries. In general, higher levels of employment and good quality work are more common in higher income countries.

The Nature of Employment Across the Globe and Associated Health Effects

Employment and high-quality work are critically important for population health and health inequalities in several interrelated ways, and the following list summarizes the importance of work to health:

1. Participation in or exclusion from the labor market determines a wide range of life chances, mainly through regular wages and salaries and social status. Deleterious economic conditions can negatively impact on employment rates.
2. Material deprivation, resulting from unemployment or low-paid work and feelings of unfair pay – such as high levels of wage disparities within organizations – contributes to physical and mental ill health.
3. Occupational position is important for people’s social status and social identity, and threats to social status from job instability or job loss affect health and well-being.
4. An adverse psychosocial work environment defined by high demand and low control, or an imbalance between efforts spent and rewards received, is associated with an increase in stress-related conditions.
5. Experiences of discrimination, harassment, and injustice aggravate stress and conflict at work, especially in times of high competition and increasing job insecurity.
6. Exposure to physical, ergonomic, and chemical hazards at the workplace, physically demanding or dangerous work, long or irregular work hours, temporary contract and shift work, and prolonged sedentary work can all adversely affect the health of working people.
7. Lack of work, inflexible, or stressful work can not only damage workers health but also have an impact on children, exacerbating the intergenerational transfer of disadvantage.

The following sections look into each of these in more detail. Some of these areas will also be the focus of other chapters in this book, and so we simply provide some examples of why we believe these to be important global challenges.

Participation in or exclusion from the labor market

There is significant variation in working patterns across the globe. In developed nations, the majority (around 85%) of those employed are working for wages, whereas in sub-Saharan Africa and South Asia, this accounts for less than 25% of workers. In the poorer regions, there is a higher percentage of own account (self-employed) and contributing family workers. The graph in the succeeding text illustrates these differences by showing the proportion of work of different statuses in 10 different countries. The percentage of workers employed in the formal compared to the informal economy varies significantly (Figure 1.2).

Figure 1.2 Distribution of Employment by Type, Selected Countries, and Latest Years.

Source: Key Indicators of the Labour Market (International Labour Organization, 2011). Reprinted with permission of the International Labour Organization.

In 2012, there was a 55.7% employment rate (the proportion of people of working age who have a job) (International Labour Organization, 2013a). However, if we consider own account workers and contributing family workers, global unemployment has reached 5.9%. It has been rising since 2007 and is forecast to continue to increase by 8 million (up to 208 million) by 2015 (International Labour Organization & International Institute for Labour Studies, 2013). Rising unemployment is particularly an issue in high-income countries, 60% of which have experienced an increase in long-term unemployment over the last year (International Labou...

Table des matières

• Cover
• Title page
• Copyright page
• About the Editors
• Contributors
• Preface
• 1 Social Determinants of Health and the Working-Age Population
• 2 An Explanatory Model of Job Insecurity and Innovative Work Behavior
• 3 The Health Consequences of Organizational Injustice
• 4 Reconsidering the Daily Recovery Process
• 5 Psychological Reactivity
• 6 Work–Family Balance and Well-Being among Japanese Dual-Earner Couples
• 7 A Life Course Perspective on Immigrant Occupational Health and Well-Being
• 8 Meaningfulness as a Resource to Mitigate Work Stress
• 9 Progress and Challenges in Occupational Health and Safety Research
• 10 The WHO Healthy Workplace Model
• 11 A Sound Change
• 12 Making Safety Training Stick
• 13 Sustainable Business Practice in a Norwegian Oil and Gas Company
• 14 An Analysis of the Coverage of Psychosocial Factors at Work in Corporate Social Responsibility Instruments and Standards
• Index
• Contemporary Occupational Health Psychology
• End User License Agreement