Trends in psychosocial working conditions 2001-2008: Evidence of narrowing inequalities? Anthony LaMontagne, Lauren Krnjacki, Anne Kavanagh & Rebecca Bentley Centre for Women s Health, Gender & Society Melbourne School of Population Health
Background Work environments: Important determinant of health Strong social gradient persists Health inequalities Focus: Psychosocial work environment
Background Psychosocial working conditions: Job stressors: Lack of job control High demands Insecurity Effort-reward imbalance Validated job stress indicators are associated with physical and mental health Prevalent and potentially ti modifiable determinants t of health
Background Working conditions vary across place and contexts However, consistent inequalities between sub-groups of population Poor conditions for lower skilled & casuals Gender differences Age differences
Monitoring working conditions Indicators used in government and other surveillance systems internationally Could be an efficient way to identify at risk groups or occupations Can guide policy and practice interventions Has potential to improve working conditions, and reduce job related stress
Monitoring Relatively little published on trends at population level Canada (1994 2001) Little change in stressors Increase in security Denmark (1990, 1995, 2000) Increase in job control Increase in security What about trends in inequalities?
Research Questions Are there inequalities in job control & job security by: Sex Age Occupational skill level Employment arrangements? Is there any change over time? Why are there inequalities by age and sex?
Methods
Data Waves 1 to 8 Employed responding persons 15 64 yrs Survey items contained in self-completion questionnaire Control five items Security two items All scored from strongly agree (1) to strongly disagree (7)
Control Two equally weighted sub-scales: Skill discretion My job often requires me to learn new skills I use many of my skills and abilities in my current job Decision authority I have lots of freedom to decide how I do my work I have a lot of say about what happens in my job I have a lot of freedom to decide when I do my job Overall internal consistency: Cronbach s Alpha = 0.40
Security One scale from two items I worry about the future of my job I have a secure future in my job Items combined with equal weighting Cronbach s alpha = 0.60
Predictors Sex (male / female) Age groups (ten year groups) Occupational skill level Five categories Based on ASCO: Skill level & skill specialization Employment arrangements Contract arrangements & work schedule Five categories (Perm FT, Perm PT, Casual & labour/ hire, fixed term, self employed)
Analysis Observed trends Differences between population groups over time Weighted to the Australian population using cross-sectional responding person weights from HILDA Differences changing over time Fitted interaction between exposures and time Unadjusted population averaged models Compare log likelihood for models with and without interaction term
Analysis Understanding differences To examine if differences by age and sex were explained by differences in types of jobs Occupational skill level l and employment arrangement fitted as co-variates Predicted values derived from population averaged longitudinal linear Predicted values derived from population averaged longitudinal linear regression
Results
Results 7,588 employed persons at baseline Including those who joined in subsequent years: Control: 55,689 observations (n = 12,324) Security: 55,736 observations (n = 13,229)
Population at baseline (2001) N ( % ) Employed persons 7,588 ( 100 ) Sex Male 4,011 ( 52.90 ) Female 3,577 ( 47.10 ) Age 15 24 1,225 ( 16.1414 ) 25 34 1,806 ( 23.80 ) 35 44 2,143 ( 28.24 ) 45 5454 1,707 ( 22.50 ) 55 64 707 ( 9.32 )
Population at baseline (2001) N ( % ) Employed persons 7,588 ( 100 ) Employee Arrangements Permanent full time 3,418 ( 45.04 ) Permanent part time 716 ( 9.44 ) Casual or Labour Hire 1,547 ( 20.39 ) Fixed Term 537 ( 7.08 ) Self Employed 1,326 ( 17.47 ) Occupational Skill Level High skill 2,432 ( 32.05 ) Moderate to high 853 ( 11.24 ) Moderate 1,026 ( 13.52 ) Low to moderate 1,779 ( 23.44 ) Low skill 1,487 ( 19.60 )
Job Control
Observed trends Observed differences in job control by: Gender Age Occupational skill level Employment arrangement Are these differences changing over time?
Job control and gender Observed trends
Job control and age Observed trends
Job control and occupational skill level Observed trends
Job control and employment arrangements Observed trends
Summary of observed trends: Job control Inequalities by sex, age, skill level and employment arrangement Some small fluctuations Possible improvements for youngest age Casuals and fixed terms Inequalities persisted over time
Job control (adjusted) To what extent are inequalities in sex and age explained by: Occupational skill level Employment arrangement
Age and emp and occ MELBOURNE SCHOOL OF POPULATION HEALTH Sex and occupational skill level 35 30 25 Males Females Percent 20 15 10 5 0 Highest skilled High Mid Middle Mid Low Lowest skilled Employment arrangement
Sex and employment arrangements 60 50 Males 40 Females Percent 30 20 10 0 Perm FT Perm PT Casual and LH Fixed Term Self Employed Employment arrangement
Job control and gender - Observed Observed trends
Job control and gender - Adjusted Adjusted for occupational skill level and employment arrangements
Age and occupational skill level 100% Pe ercent 80% 60% 40% Lowest skilled Mid Low Middle High Mid 20% Highest skilled 0% 15 24 25 34 35 44 45 54 55 64 Age group
Age and employment arrangements 100% Percent 80% 60% 40% 20% Self Employed Fixed Term Casual and LH Perm PT Perm FT 0% 15 24 25 34 35 44 45 5454 55 64 Age group
Job control and age - Observed Observed trends
Job control and age - Adjusted Adjusted for occupational skill level and employment arrangements
Summary of job control findings Differences by sex, age, skill level and employment arrangement Persisted over time Age and sex differences attenuated when controlling for skill level and work arrangement
Job Security
Observed trends Observed differences in job security by: Sex Age Occupational skill level Employment arrangement Are these differences changing over time?
Job security and gender Observed trends
Job security and age Observed trends
Job security and occupational skill level Observed trends
Job security and employment arrangements Observed trends
Summary of observed trends: Job security Inequalities by sex, age, skill level and employment arrangement Some small fluctuations Possible improvements for youngest age? Casuals and fixed terms? Inequalities persisted over time
Results: Security (adjusted) To what extent are inequalities in sex and age explained by: Occupational skill level Employment arrangement
Job security and gender - Observed Observed trends
Job security and gender - Adjusted Adjusted for occupational skill level and employment arrangements
Job security and age - Observed Observed trends
Job security and age - Adjusted Adjusted for occupational skill level and employment arrangements
Summary: Job security findings Overall job security showed a small increase from 2001 2007, drop in 2008 (GFC?) Persisting differences by sex, age, skill level and work arrangement In contrast to control, age and sex differences not g attenuated when controlling for skill level and employment arrangements
Main Findings & Implications
Main findings and implications: Job control Inequalities persist over time for all groups Small fluctuations but need further monitoring Gender differences Mostly explained by composition of the workforce Social policy issue Some persisting disparity within same jobs
Main findings and implications: Job control Age differences Mostly explained by composition of the workforce Still young people lowest control Mixed group: who does it matter for? Mental illness early in life due to work stress Intervention to improve job control in low skilled and precarious employment may decrease inequalities Further interventions may be needed directly for women and younger aged
Main findings and implications: Job security Differences between groups over time persist Sex differences not attenuated once adjusted Men perceive security to be lower at given occupational skill and employment arrangements? Possibly equally insecure but in different industries? Nurses / teachers vs. Seasonal workers / labourers? Gendered importance of work Different roles in household?
Main findings and implications: Job security Age differences not attenuated once adjusted Different perception of security different aged groups Lowest were 35-44 and 45-54 year olds Address job security by lowest skill level employees and precarious employment arrangements
Implications for policy and practice Strategies are available to improve conditions Organizational or structural approaches: Control Increasing participation of employees in decision making Participatory staff meetings Opportunity for reduced or flexible work hours Security Assist individual to deal with precarious employment
Strengths and Limitations Limited measures: No demand d measure (balance with control) Low reliability of measures Job security measure used here associated with mental health Control measure lower internal consistency (0.4) However shown to predict SF-36 mental health outcomes
Strengths and Limitations Longitudinal survey: Detailed picture of time trends within and between person Changes in working conditions due to changes in labour force composition not efficiently captured here ABS data indicated proportion of permanent to precarious has not changed overt time Repeat cross sectional and longitudinal data ideal Sample less representative due to attrition biased to high h SES groups
Summary Persisting inequalities in job control and job security Lower skilled occupations and casuals Gender differences Age differences Small fluctuations needs continued monitoring Age and sex differences in job control could be addressed through adjustments in the composition of the workforce Addressing inequalities could help to reduce health inequalities