Few studies have addressed the effect of gender policies on women's health and gender inequalities in health. This study aims to analyse the relationship between the orientation of public gender equality policies and gender inequalities in health in European countries, and whether this relationship is mediated by gender equality at country level or by other individual social determinants of health. A multilevel cross-sectional study was performed using individual-level data extracted from the European Social Survey 2010. The study sample consisted of 23,782 men and 28,655 women from 26 European countries. The dependent variable was self-perceived health. Individual independent variables were gender, age, immigrant status, educational level, partner status and employment status. The main contextual independent variable was a modification of Korpi's typology of family policy models (Dual-earner, Traditional-Central, Traditional-Southern, Market-oriented and Contradictory). Other contextual variables were the Gender Empowerment Measure (GEM), to measure country-level gender equality, and the Gross Domestic Product (GDP). For each country and country typology the prevalence of fair/poor health by gender was calculated and prevalence ratios (PR, women compared to men) and 95% confidence intervals (CI) were computed. Multilevel robust Poisson regression models were fitted. Women had poorer self-perceived health than men in countries with traditional family policies (PR = 1.13, 95%CI: 1.07-1.21 in Traditional-Central and PR = 1.27, 95%CI: 1.19-1.35 in Traditional-Southern) and in Contradictory countries (PR = 1.08, 95%CI: 1.05-1.11). In multilevel models, only gender inequalities in Traditional-Southern countries were significantly higher than those in Dual-earner countries. Gender inequalities in self-perceived health were higher, women reporting worse self-perceived health than men, in countries with family policies that were less oriented to gender equality (especially in the Traditional-Southern country-group). This was partially explained by gender inequalities in the individual social determinants of health but not by GEM or GDP.

This study explores the association between involuntarily working less or more than the standard workweek and poor mental well-being, and whether this relationship is dependent upon (changing) national-level unemployment and gross domestic product growth rates. Data from the European Social Survey Round 2 (2004-2005) and Round 5 (2010) were analyzed. The sample included 16,224 male and 16,184 female employees. Mental well-being was assessed by the World Health Organization Well-being Index. Three-level linear multilevel modeling was used to account for clustering of employees within research years and countries. Working involuntary long hours was positively associated with poor mental well-being for men. For women, working voluntary long, involuntary long, and involuntary short hours were positively associated with poor mental well-being. The mental well-being of women working voluntary and involuntary long hours was negatively influenced by deteriorating economic conditions. This study suggests women are more vulnerable to the effects of long working hours and working hours mismatch on mental well-being, especially during difficult economic periods.

Although many governments actively stimulate self-employment, their work-related mental well-being remains understudied. The aim of current study is to investigate the mental well-being of different types of self-employed, testing whether mental well-being differences among self-employed are explained by the presence of work characteristics that are in accordance with the ideal-typical image of the “successful entrepreneur” (e.g. creativity, willingness to take risks, innovativeness, high intrinsic motivation, skilfulness and the ability of recognizing opportunities). Moreover, we investigate the relation of country-level “entrepreneurial climate” and the individual mental well-being of self-employed. For this purpose, data from the European Working Conditions Survey, round 6 (2015) was analysed, including 5448 cases, originating from the 28 EU-member states. Multilevel random intercepts modelling was used to investigate associations of both individual- and country-level characteristics with mental well-being. We found that motivation, the ability to recognize opportunities, and finding it easy to be self-employed positively influences the mental well-being of self-employed. Respondents with these characteristics are often medium-big employers, while farmers, dependent freelancers and own account workers generally have less of these features and tend to have lower levels of mental well-being. At the country-level, positive entrepreneurship perception relates to more advantageous mental health scores in self-employed. These results implicate that policies promoting self-employment should be (more) concerned with the work-related characteristics of (future) self-employed.

IntroductionThere is the tendency in occupational health research of approximating the ‘changed world of work’ with a sole focus on the intrinsic characteristics of the work task, encompassing the job content and working conditions. This is insufficient to explain the mental health risks associated with contemporary paid work as not only the nature of work tasks have changed but also the terms and conditions of employment. The main aim of the present study is to investigate whether a set of indicators referring to quality of the employment arrangement is associated with the well-being of people in salaried employment. Associations between the quality of contemporary employment arrangements and mental well-being in salaried workers are investigated through a multidimensional set of indicators for employment quality (contract type; income; irregular and/or unsocial working hours; employment status; training; participation; and representation). The second and third aim are to investigate whether the relation between employment quality and mental well-being is different for employed men and women and across different welfare regimes.MethodsCross-sectional data of salaried workers aged 15–65 from 21 EU-member states (n =11,940) were obtained from the 2010 European Social Survey. Linear regression analyses were performed.ResultsFor both men and women, and irrespective of welfare regime, several sub-dimensions of low employment quality are significantly related with poor mental well-being. Most of the significant relations persist after controlling for intrinsic job characteristics. An insufficient household income and irregular and/or unsocial working hours are the strongest predictors of poor mental well-being. A differential vulnerability of employed men and women to the sub-dimensions of employment quality is found in Traditional family and Southern European welfare regimes.ConclusionsThere are significant relations between indicators of low employment quality and poor mental well-being, also when intrinsic characteristics of the work task are controlled. Gender differences are least pronounced in Earner-carer countries.

In this study, the authors investigate the health associations of different employment arrangements in the contemporary European labor market. In doing so, a new approach based on the concept of “employment quality” is introduced. Employment quality refers to the multiple dimensions characterizing the employment situation of wage- and self-employed (European Working Conditions Survey 2015 – N = 31,929). Latent class cluster analyses were applied to construct an overarching typology of employment quality for the waged and self-employed. Using logistic regression analyses, strong associations were found with mental well-being and self-reported general health, pointing at a disadvantaged situation for the most precarious employment arrangements. The study shows that employment quality should be taken seriously as a health determinant both among waged workers and the self-employed. Our (novel) holistic approach offers an alternative to current analyses of the health associates of labor market segmentation that were criticized for being overly simplistic and amounting to inconclusive findings.

BackgroundThe objective of this study is to examine social inequalities in employee mental well-being, using relational social class indicators. Relational social class indicators are based on theoretical insights about the mechanisms generating social (health) inequalities. Additionally, it is examined whether the psychosocial work environment and employment quality act as intermediary determinants of social class inequalities in mental well-being, simultaneously testing the mediation (differential exposure) and moderation (differential vulnerability) hypotheses.MethodsData from the European Social Survey Round 2 (2004/5) and Round 5 (2010) were analysed. Mental well-being was assessed by the WHO Well-being Index. The measure for social class was inspired by E.O. Wright’s class scheme. Three-level linear multilevel modelling was used to account for clustering of employees within research years and countries.ResultsWe found social class inequalities in mental well-being in the European working population for both men and women. Compared to unskilled workers, managers reported the best mental well-being, while supervisors held an intermediary position. As regards the mediation hypothesis, an unfavourable psychosocial work environment and low-quality employment conditions mediated the relation between social class and poor mental well-being in both men and women. However, low quality of employment relations only mediated the “social class-mental well-being” association in the male sample. As regards the moderation hypothesis, modification effects were seen for the psychosocial work environment and employment conditions in both men and women.ConclusionRelational indicators of social class are related to mental well-being in European employees. Relational accounts of social class are complementary to stratification indicators in social epidemiology. From a policy perspective, better employee mental well-being and less social class inequality could be achieved through initiatives addressing the unequal social relations generated by structural positions in the labour process.

The relation between "neo-Marxian" social class (NMSC) and health in the working population has received considerable attention in public health research. However, less is known about the distribution of mental well-being according to NMSC in a European context. The objectives of this study are (i) to analyse the association of mental well-being and NMSC among employees in Europe (using a welfare regime typology), (ii) to investigate whether the relation between NMSC and mental well-being is the same in women compared to men within each welfare regime, and (iii) to examine within each welfare regime the role of the gender division of labour and job quality as potential mediating factors in explaining this association. Data from the European Social Survey Round 5 (2010) were analysed. Mental well-being was assessed by the WHO Well-being Index. Social class was measured through E.O. Wright's social class scheme. Models separated by sex were generated using Poisson regression with a robust error variance. The associations were presented as prevalence ratios with 95% confidence intervals. Women reported NMSC differences in mental well-being in State corporatist/family support and Southern welfare regimes. Men reported NMSC differences in mental well-being in all but the Basic security/market-oriented welfare regimes. Gender inequalities were more marked and widespread in Basic security/market-oriented welfare regimes. In all welfare regimes job quality (partly) explained NMSC inequalities in mental well-being for men, the role of the gender division of labour was unclear. This study showed that the relationship between NMSC and mental well-being among employees differs by gender and welfare regimes. It confirms the importance of NMSC and welfare regimes to explain gender and social class inequalities in mental well-being.

The aim of this article is to explain the results of the SOPHIE project regarding the effect of gender policies on gender inequalities in health in Europe. We start with the results of a systematic review on how gender regimes and gender equality policies at the country level impact women's health and gender inequalities in health. Then, we report on three empirical analyses on the relationship between different family policy models existing in Europe and gender inequalities in health. Finally we present four case studies on specific examples of gender policies or determinants of gender inequalities in health. The results show that policies that support women's participation in the labor force and decrease their burden of care, such as public services and support for families and entitlements for fathers, are related to lower levels of gender inequality in terms of health. In addition, public services and benefits for disabled and dependent people can reduce the burden placed on family caregivers and hence improve their health. In the context of the current economic crisis, gender equality policies should be maintained or improved.