Gender and social differences in self-reported health in 31 countries in Europe

Background: The aim of this study was to investigate the association between occupational category and self-reported health (SRH) in men and women in Europe. Methods: The study was based on a sample of 17005 workers (8484 men and 8521 women) from the nationally representative European Quality of Life Survey (EQLS) conducted in 31 countries in Europe in 2007. SRH was measured using a single item, and dichotomised into good (very good, good) and poor (fair, bad, very bad) health. Occupation was classified into four categories according to the International Standard Classification of Occupations (ISCO-2008). The 31 countries were grouped into five welfare state regimes. The association between occupation and SRH was examined using multilevel logistic regression adjusted for age, urbanization level and household size. Interactions were also tested in the logistic regression models. Results: The prevalence of poor SRH was greater for women than for men, this was also observed in each occupational category. Differences in poor SRH were observed between regimes, workers living in Eastern countries being more likely to be in poor health. An interaction was found between gender and regimes (p=0.024), gender differences being stronger in Eastern countries. We observed significant social differences for SRH, the prevalence of poor health being higher in manual workers in both genders. This result was confirmed in most regimes. After adjusting for covariates, there was still evidence of strong social differences in SRH (ORmen=1.80, 95%CI:1.48–2.18; ORwomen=1.41, 95%CI:1.16–1.70 for manual workers). An interaction between occupation and gender was significant (p=0.007), underlining the stronger social differences in SRH for men. Conclusions: SRH appeared to be strongly patterned by occupational group and gender. Our results showed marked social differences in SRH, manual workers being more likely to be in poor health. Forthcoming studies will be performed to better understand these gender, social and country differences in Europe.

Literatur:

B. Aldabe, R. Anderson, M. Lyly-Yrjanainen, A. Parent-Thirion, G. Vermeylen, C. C. Kelleher, and I. Niedhammer. Contribution of material, occupational, and psychosocial factors in the explanation of social inequalities in health in 28 countries in Europe. J.Epidemiol.Community Health, 2010.