Department of Medical Sociology, University Clinic Duesseldorf, University of Duesseldorf, PO Box 10 10 07, D-40001 Duesseldorf, Germany.
J Epidemiol Community Health. 2011 Sep;65(9):793-9. doi: 10.1136/jech.2009.098541. Epub 2010 Aug 6.
Recent analyses explored associations of welfare state regimes with population health, with particular interest in differences between social protection-oriented versus more liberal regimes. Little is known about such associations with work-related health. The aims of this contribution are (1) to study variations of quality of work according to type of welfare regime and (2) to analyse differences in the size of effects of quality of work on workers' health according to type of welfare regime.
The authors use cross-sectional and longitudinal data from two studies ('Survey of Health, Ageing and Retirement in Europe' and the 'English Longitudinal Study on Ageing') with 9917 employed men and women (aged 50 to 64) in 12 European countries. Psychosocial quality of work is measured by low control and effort-reward imbalance at work. Depressive symptoms are introduced as a health indicator. Linear multilevel models and logistic regression analyses are performed to test the hypotheses. In addition to the welfare regime typology, the authors introduce labour policy and economy-related macro indicators.
Between-country variations in quality of work are largely explained by macro indicators and welfare regimes, with poorer quality of work in countries with less emphasis on older workers' protection. Moreover, in the Liberal and Southern welfare regime, effects of quality of work on depressive symptoms are relatively strongest (adjusted ORs varying from 1.45 to 2.64).
Active labour policies and reliable social protection measures (eg, Scandinavian welfare regime) exert beneficial effects on the health and well-being of older workers. More emphasis on improving quality of work among this group is warranted.
最近的分析探讨了福利国家模式与人口健康之间的关系,特别关注社会保护导向型模式与更自由的模式之间的差异。关于这种与工作相关的健康差异的研究还很少。本研究的目的是:(1) 根据福利制度类型研究工作质量的变化;(2) 分析工作质量对工人健康影响的大小在不同福利制度类型之间的差异。
作者使用了来自两项研究(“欧洲健康、老龄化和退休调查”和“英国老龄化纵向研究”)的横断面和纵向数据,共涉及 12 个欧洲国家的 9917 名在职男性和女性(年龄在 50 至 64 岁之间)。工作的心理社会质量通过工作中的低控制和努力-回报失衡来衡量。抑郁症状被引入作为健康指标。采用线性多层模型和逻辑回归分析来检验假设。除了福利制度类型外,作者还引入了劳动政策和与经济相关的宏观指标。
工作质量的国家间差异在很大程度上可以用宏观指标和福利制度来解释,在对老年工人保护力度较弱的国家,工作质量较差。此外,在自由和南方福利制度下,工作质量对抑郁症状的影响相对最强(调整后的比值比从 1.45 到 2.64 不等)。
积极的劳动政策和可靠的社会保护措施(如斯堪的纳维亚福利制度)对老年工人的健康和福祉产生有益影响。需要更加重视提高这一群体的工作质量。