ESIMar (Mar Nursing School), Parc de Salut Mar, Universitat Pompeu Fabra-Affiliated, Mar Campus, 08003, Barcelona, Spain.
SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Int Arch Occup Environ Health. 2022 Sep;95(7):1463-1480. doi: 10.1007/s00420-022-01839-7. Epub 2022 Feb 10.
The aim of this article was to examine the relationship between precarious employment (PE), welfare states (WS) and mental health in Europe from a gender perspective.
Data were derived from the European Working Conditions Survey 2015. PE was measured through the Employment Precariousness Scale for Europe (EPRES-E), validated for comparative research in 22 European countries, and categorized into quartiles. Countries were classified into Continental, Anglo-Saxon, Scandinavian, Southern and Central-Eastern WS. Mental health was assessed through the WHO-5 Well-Being Index and dichotomized into poor and good mental health. In a sample of 22,555 formal employees, we performed gender-stratified multi-level logistic regression models.
Results showed greater prevalences of PE and poor mental health among women. However, the association between them was stronger among men. Cross-country differences were observed in multi-level regressions, but the interaction effect of WS was only significant among women. More precisely, Central-Eastern WS enhanced the likelihood of poor mental health among women in high precarious employment situations (quartiles 3 and 4).
These findings suggest the interaction between contextual and individual factors in the production of mental health inequalities, both within and across countries. They also call for the incorporation of gender-sensitive welfare policies if equitable and healthy labor markets are to be achieved in Europe.
本文旨在从性别视角审视欧洲不稳定就业（PE）、福利国家（WS）与心理健康之间的关系。
数据来自 2015 年欧洲工作条件调查。PE 通过欧洲就业不稳定量表（EPRES-E）进行衡量，该量表在 22 个欧洲国家进行了比较研究验证，并分为四等分。国家分为大陆、盎格鲁-撒克逊、斯堪的纳维亚、南欧和中东欧 WS。心理健康通过世界卫生组织-5 幸福感指数进行评估，并分为心理健康良好和不佳两类。在 22555 名正式员工的样本中，我们进行了性别分层多水平逻辑回归模型分析。
结果显示，女性中不稳定就业和心理健康不佳的比例较高。然而，这种关联在男性中更为强烈。多水平回归中观察到了国家间的差异，但 WS 的交互效应仅在女性中显著。具体而言，中东欧 WS 增强了高不稳定就业情况下（第 3 和第 4 四分位数）女性心理健康不佳的可能性。
这些发现表明，在国家内部和国家之间，心理不平等的产生受到了情境和个体因素的相互作用的影响。如果要在欧洲实现公平和健康的劳动力市场，还需要制定性别敏感的福利政策。
