This document discusses the relationship between gender divisions of work, working time, and health. It outlines different welfare state regimes and their approaches to work-family balance, including part-time work and long working hours. Nordic countries promote a dual-earner/dual-carer model while others promote traditional gender roles or women working part-time. Women employed full-time tend to have better health than homemakers. Long working hours and balancing work and family demands are associated with poorer health, especially among women in Southern European countries where traditional gender roles dominate. Part-time work is often of poorer quality with less training, lower wages and job insecurity.

1. Gender division of work,
working time and health
Lucía Artazcoz
Public Health Agency of Barcelona

2. Presentation outline
 Conceptual framework based on the
sexual division of work
 Employment-family balance
 Part-time work
 Long working hours

3. Conceptual framework

4.  Traditional occupational health
 Work, a potential source of health
hazards
 Work as a social determinant of health
 Occupational social-class inequalities
 Domestic and family work and health

5.  Gender division of work
 Interaction between employment and the family
sphere
 Family sphere:
 Domestic and caring work
 Breadwinner role
 Intersection with other axes of inequalities:
 Individual level: Social class (ethnicity, immigration)
 Contextual level: Welfare state regimes

6. The sexual division of work in
Europe

7. Labour force participation in the EU-27
by country and sex in 2013
Eurostat, Labour Force Survey

8. Welfare state regimes: Family
and labour market models

9. Welfare state regimes and
family models in Europe
 Nordic countries
 Double earner/double carer
 Continental countries
 Traditional family model with support to families
 Southern-European countries
 Traditional family models, with no support to families
 Post-comunist countries
 Double earner/women carers
 Anglo-Saxon countries
 Market-oriented family models

10. Time devoted to domestic work among
workers married or cohabiting
0% 20% 40% 60% 80% 100%
Continental
Ireland/UK
Eastern Europe
Southern Europe
Nordic
Continental
Ireland/UK
Eastern Europe
Southern Europe
Nordic
Everyday >=1 hours Every 2nd day<1 hour 1-2 a week 1-2 a month 1-2 a year Never
Men
Women
Source: European Working Conditions Survey, 2010

11. Person who contributes the most to the household income
among workers married or cohabiting
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Continental
Ireland/UK
Eastern Europe
Southern Europe
Nordic
Continental
Ireland/UK
Eastern Europe
Southern Europe
Nordic
Yes No Both equally
Men
Women
Source: European Working Conditions Survey, 2010

12. Explaining the gender division
of domestic and family work
 Negotiation between partners
 Better position of partners with more economic resources
 More equal economic positions between partners, less
domestic work for women but not more domestic work for
men (Kroska, 2004)
 Stable pattern of male share in domestic work
across life
 Motherhood increase gender inequalities in
domestic work (Baxter et al. 2008)
 Gender role expectations (Geist, 2005)
 Societal norms, gender and family policies

13. Nordic model
 Women working full-time or long part-
time
 Family care outside families
 More policies for promoting women
participation in the labour market than
men participation in domestic work

14. Other countries
 Continental countries
 Promotion of women working part-time
 Southern European countries
 Women working full-time or homemakers
 Low labour market participation of women
 Eastern European countries
 Women working full-time
 Women as carers
 Social care for 3-6 years old children
 UK
 Promotion of women working part-time
 Low salaries and poor working conditions among women

15. The gender division of work
and health

16. Employed women and full-time
homemakers
 Employed women with better health than full-time
homemakers (Artazcoz et al. 2007)
 Benefits of women’s employment
 Opportunities to build self-esteem and confidence in one’s
decision-making,
 Social-support
 Experiences that enhance life satisfaction
 Economic independence
 Poorer health-related behaviours among female
manual workers (Artazcoz et al. 2004)
 Insufficient sleep hours
 Lower physical activity in the leisure time

17. The case of Spain:
Changing patterns with the
economic crisis
Combining employment and family
demands and health: the intersection with
social class

18. 0
1
2
3
4
Mala
salud
Poor general
health
Long-standing
Limiting illness
At least one
Chronic condition
Risk
Sleep < 6 hours
3
4
>4 persons
3
4
>4 persons
3
4
>4 persons
3 4
>4 persons
2 22 2
Female manual workers

19. 0
1
2
3
4
Mala
salud
Poor general
health
Poor mental
health
Sleep < 6 hours
Risk
Leisure time
sedentarism
3
4
>4 persons
3 4
>4 persons
3
4
>4 persons
3 4
>4 persons
2 22 2
Female manual workers

20. 0
1
2
3
4
Mala
salud
Poor general
health
Poor mental
health
Sleep < 6 hours
Risk
Leisure time
sedentarism
3
4
>4 persons
3
4
>4 persons
3 4
>4 persons
3 4
>4 persons
2 22 2
Male manual workers

21.  Data from the 2010 European Working Conditions Survey
 Sample: Workers married or cohabiting
 Employment demands: working hours (< 30, 30-40, 41-50 and
<50)
 Household composition
 Number of children
 Living with older than 64
 Partner’s employment status
 Health outcomes
 General health status
 Psychological wellbeing

22.  Continental and Southern European countries:
 Long working hours and family demands associated with health status in both
sexes, although these associations are stronger and more consistent among
women;
 Men from Southern European countries: Poor health status and
psychological wellbeing among living with other than 64
 Anglo-Saxon countries:
 Association between long working hours and family demands and health mainly
limited to men
 Women: The only country where part-time was related to better health status
 Nordic and Eastern European countries:
 Long working hours and family demands largely unassociated with poor health
outcomes in both sexes.

23. Understanding part-time, long
working hours and health
Welfare state
models (cultural
aspects)
Family models
Carer Part-time work
Breadwinner
Long working
hours
Involuntary or
forced
Poor
employment
and working
conditions and
poor health
Labour market
characteristics
(regulation)
Bargaining
power
The importance of economic vulnerability
… and the crisis

24. Part-time work and employment
and working conditions

25. Part-time work in the EU-27 by country
and sex in 2013
Eurostat, Labour Force Survey

26. Involuntary part-time work in the EU-
27 by country and sex in 2013
Eurostat, Labour Force Survey

27. Dimensions of job quality
Source: Eurofound, 2012

28. (2013)

29. In search of good quality part-
time employment

30. Quality part-time:
Differences between countries
 Differences between countries:
 Definition
 Incidence
 Available information
 Good quality part-time jobs: Sweden
and The Netherlands
 Poor quality part-time jobs: United
Kingdom

31. Job quality and part-time in
Europe (1)
 Job security
 Part-time more insecure
 Training opportunities
 Less training opportunities
 Less promotion prospects
 Intrinsic job quality
 Concentration in low-skilled jobs
 Higher levels of monotony
 Lower levels of task complexity and problem-solving tasks
(Sandor, 2011)
 Poor economic and social integration
 Voluntary or involuntary
 Attention to mini jobs (Burchell et al.)
 Occupational downgrading (higher in the UK)

32. (2010)

33. (2010)

34. Job quality and part-time in
Europe (2)
 Earnings and earnings progression
 Lower average hourly earning in almonst all
countries (Kalleberg, 2006)
 Small differences in Norway and the Netherlands
 Largest gap in the United Kingdom
 Exposure to health hazards
 Lower exposure to safety and ergonomic
hazards; higher exposure to psychosocial
hazards

35. Job quality and part-time in
Europe (3)
 Working-time quality
 Part-timers more likely to have control
over their working-time
 Intensification of work? (Fagan et al.
2008)
 Irregular working-times? Unpredictable
working hours? On call? (Plantenga and
Remery, 2009)

36. Long working hours and
health

37. Working hours among men in
Europe, 2010
0%
20%
40%
60%
80%
100%
Continental Anglo-Saxon Eastern Southern Nordic
<30 31-40 41-50 51-60
European Working Conditions Survey, 2010

38. Working hours among women
in Europe, 2010
0%
20%
40%
60%
80%
100%
Continental Anglo-Saxon Eastern Southern Nordic
<30 31-40 41-50 51-60

39. Karoshi: about 10000 deaths a
year in Japan

40. Long working hours and health
status in Spain

41. In some circumstances, working
41-60 hours associated with…
 Poor general health
 Poor mental health
 Job dissatisfaction
 Hypertension
 Smoking
 Sedentarism in the leisure time

42. Proposed model for explaining the relationship
between moderately long working hours and health
status

43. Long working hours and health
status in Europe

44. Long working hours and health
status in Europe

45. Long working hours and health
status in Europe (2005)
 In all countries, working long hours related
to poor health but the association was
stronger and more consistent among men
from Anglo-Saxon countries;
 Stronger association among men in
countries with male breadwinner models,
similar among men and women from Nordic
countries, and stronger among women from
Eastern European countries.

46. Opting out of the 48-hour
week in the UK
 Workers 18 or over who want to work more than 48 hours a
week, can choose to opt out of the 48-hour limit.
 This could be for a certain period or indefinitely. It must be
voluntary and in writing.
 It can’t be contained in an agreement with the whole
workforce. However, employers are allowed to ask
individual workers if they’d be willing to opt out.
 An employer shouldn’t sack or unfairly treat a worker (eg
refused promotion) for refusing to sign an opt-out.
Source: https://www.gov.uk/maximum-weekly-working-hours/weekly-maximum-working-hours-and-opting-out

48.  As the directive stands there is only work and
resting—no in between such as on-call times, when
the doctor may not actually be working. The
commission is also concerned about the use of opt
outs, which give individuals the right to opt out of the
weekly limit on working hours. Doctors may opt out
for various reasons, such as the need to earn
more money or to receive more training, or
simply due to pressure exerted by the trust they
work for. The more doctors opt out, the easier it
becomes for trusts to comply with the requirements
of the directive.

49.  Professionals often choose to work long
hours because they enjoy their work, and
from a desire to provide a good service and
to improve their expertise in their chosen
profession. Although limits need to be set
on the number of hours people work, the
change from 56 to 48 hours is a step too
far. The creation of complicated rotas, full
shifts, and cross cover is not the solution to a
fundamentally flawed reduction in hours of
work.

50. Gender division of work,
working time and health
Lucía Artazcoz
Public Health Agency of Barcelona