Physical and psychosocial work factors as explanations for social inequalities in self-rated health
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ORIGINAL ARTICLE
Physical and psychosocial work factors as explanations for social inequalities in self‑rated health Rasmus Luca Lyager Brønholt1 · Matilde Bøgelund Hansen1 · Sabrina Islamoska1 · Ulla Christensen1 · Matias Brødsgaard Grynderup2 · Kirsten Nabe‑Nielsen1 Received: 20 November 2019 / Accepted: 9 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective We investigated the contribution of physical and psychosocial work factors to social inequalities in self-rated health (SRH) in a sample of Danish 40 and 50 years old occupationally active women and men. Methods In this longitudinal study, the study population consisted of 3338 Danish women and men. Data were collected by postal questionnaires in 2000 (baseline) and 2006 (follow-up). The independent variable, socioeconomic position (SEP), was assessed by the highest achieved educational level at baseline. We conducted gender-stratified parallel multiple mediation analyses. In the mediation analyses, SEP was categorised as SEP I, II, III, VI and V among men. Among women, SEP was dichotomised into SEP I–IV and V. The outcome, SRH, was assessed at baseline and follow-up. A wide range of physical and psychosocial work factors were included as potential mediators. Results We found a social gradient in SRH across all levels of SEP among men. Among women, we only found a poorer SRH among those with the lowest SEP. Mediation analyses showed that work factors together accounted for 56% of the social inequalities in SRH among men and 44% among women. In both genders, ergonomic exposures and job insecurity seemed to play the major role for social inequalities in SRH. For women only, we also found noise to contribute to the social inequalities in SRH. Conclusion Physical and psychosocial work factors partially explained social inequalities in SRH among both genders. Improvement of the working environment can potentially contribute to the reduction of social inequalities in health. Keywords Self-assessed health · Physical working conditions · Psychosocial working conditions · Social class
Introduction Social inequalities in health have been widely documented, for example, in terms of higher morbidity and mortality among individuals with lower socioeconomic position (SEP) compared with individuals with higher SEP (Lahelma et al. 2015; Mackenbach et al. 2008; Marmot and Bell 2016). Moreover, even though morbidity and mortality have been decreasing for several years, social inequalities in health persist and may even have widened (Diderichsen et al. 2012; Mortensen et al. 2016). Social inequalities have * Kirsten Nabe‑Nielsen [email protected] 1
Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark
Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen K, Denmark
2
been studied in regards to a wide range of health outcomes including self-rated health (SRH) (Baldi et al. 2013; Cockerham 2017; Torsheim et al. 2018). SRH has been shown
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