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 Men Women Source: European Working Conditions Survey, 2010

11. Person who contributes the most to the household income among workers married or cohabiting 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 in the labour market 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: Women in the labour market 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. The case of Spain: Changing patterns with the economic crisis Combining employment and family demands and health: the intersection with social class

17. Poor general health Long-standing Limiting illness At least one Chronic condition Risk Sleep < 6 hours 3 4 >4 persons 3 4 3 4 3 4 2 2 2 2 Female manual workers

18. Poor general health Poor mental health Sleep < 6 hours Risk Leisure time sedentarism 3 4 >4 persons 34 3 4 3 4 2 2 2 2 Female manual workers

19. Poor general health Poor mental health Sleep < 6 hours Risk Leisure time sedentarism 3 4 >4 persons 3 4 3 4 3 4 2 2 2 2 Male manual workers

20. 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

21. 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.

22. Understanding part-time, long working hours and health Welfare state models (cultural aspects) Family modelsCarerPart-time workBreadwinner 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

23. Part-time work and employment and working conditions

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

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

26. Dimensions of job quality Source: Eurofound, 2012

27. (2013)

28. In search of good quality part- time employment

29. 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

30. 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)

31. (2010)

33. 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

34. 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)

35. Long working hours and health

36. Working hours among men in Europe, 2010 European Working Conditions Survey, 2010

37. Working hours among women in Europe, 2010

38. Karoshi: about 10000 deaths a year in Japan

39. Long working hours and health status in Spain

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

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

42. Long working hours and health status in Europe

44. 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.

45. 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-outhttps://www.gov.uk/maximum-weekly-working-hours/weekly-maximum-working-hours-and-opting-out

47. 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.

48. 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.

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