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Domestic workload and multiple roles: epidemiological findings on health and sickness absence in women
Institutionen för medicin, Göteborgs Universitet.ORCID iD: 0000-0002-4773-1447
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The objective of this thesis was to analyse the importance of specific exposures in women’s lives to health and sickness absence; more precisely to study the association between domestic work, multiple roles and the experience of being sick-listed, and self-rated health, psychiatric disorders and sickness absence. Method: The thesis was based on two datasets. ‘Women’s health and living conditions’ (WHL) is a cross-sectional study on 1 417 employed women aged 17 to 64 years old. Data was collected with a questionnaire, and register and employee data on sickness absence. ‘Women and alcohol in Göteborg’ (WAG) is a prospective cohort study on 1 799 women in eight age cohorts born from 1925 to 1980. Data was collected with a screening questionnaire, interviews and register-based sickness absence. Several aspects of domestic work, multiple roles and experience of sickness absence were analysed in relation to self-rated health (SF-36), psychiatric disorders (DSM-III and IV) and sickness absence. The study on multiple roles emanated from the role strain and role enhancement hypotheses and roles were analysed as single roles and as combinations of roles. Changes in self-rated physical health were assessed in relation to experience of sickness absence over five year. Cross-sectional and longitudinal analyses were conducted using multivariate regressions analyses. Results: Domestic job strain and a lack of domestic work equity and marital satisfaction were associated with lower self-rated health particularly vitality and mental health. The former was not associated to sickness absence, but the latter was. Women with domestic workload due to children and adults with special needs had higher odds for medium-long sick-leave spells, while parental responsibility gave lower odds for any sick-leave spell. Occupation was related to lower odds for poor self-rated physical health and sickness absence, while the parental role was associated with higher odds for sickness absence. Compared with women who had all three roles women with occupation and partner role had lower odds for negative health outcomes. Support was found for the role strain hypothesis in the cross-sectional analyses of role combinations while neither of the hypotheses was supported in the five year follow up. A lower proportion of those who had experience of being sick-listed reported good health at both baseline and follow up. Women with psychiatric disorders had higher odds for a change from poor to good self-rated physical health over the five years if they had been sick-listed. Conclusion: Domestic workload was associated to health and sickness absence in women, but there were inconsistencies in the findings on children and being a parent and on multiple roles. From a public health perspective, deeper knowledge on the importance of women’s engagement domestic work and its different dimensions is important for promoting women’s health. A multidimensional assessment of domestic work is important and the content and complexity of domestic work and of different roles needs to be further explored in relation to health and sickness absence in women.

Place, publisher, year, edition, pages
Göteborg: Department of Public Health and Community Medicine/Social Medicine, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg , 2008.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hh:diva-21061ISBN: 978-91-628-7559-6 (print)OAI: oai:DiVA.org:hh-21061DiVA: diva2:587738
Public defence
2008-01-24, hörsal 2118, Arvid Wallgrens Backe 2, Göteborg, 09:00 (English)
Available from: 2013-01-16 Created: 2013-01-15 Last updated: 2017-02-14Bibliographically approved
List of papers
1. Associations between strain in domestic work and self-rated health: A study of employed women in Sweden
Open this publication in new window or tab >>Associations between strain in domestic work and self-rated health: A study of employed women in Sweden
2008 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 36, no 1, 21-27 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to analyse the association between strain in domestic work and self-rated health among employed women in Sweden, using two different methods of measuring strain in domestic work. Methods: Questionnaire data were collected on health and living conditions in paid and unpaid work for employed women (n=1,417), aged 17-64 years. "Domestic job strain" was an application of the demand-control model developed by Karasek and Theorell, and "Domestic work equity and marital satisfaction" was measured by questions on the division of and responsibility for domestic work and relationship with spouse/cohabiter. Self-rated health was measured using the SF-36 Health Survey. Associations were analysed by bivariate and multivariate linear regression analyses, and reported as standardized regression coefficients. Results: Higher strain in domestic work was associated with lower self-rated health, also after controlling for potential confounders and according to both strain measures. "Domestic work equity and marital satisfaction" showed for example negative associations with mental health β -0.211 (p<0.001), vitality β -0.195 (p<0.001), social function -0.132 (p<0.01) and physical role β -0.115 (p<0.01). The highest associations between "Domestic job strain" and SF-36 were found for vitality β -0.156 (p<0.001), mental health β -0.123 (p<0.001). Conclusions: Strain in domestic work, including perceived inequity in the relationship and lack of a satisfactory relationship with a spouse/cohabiter, was associated with lower self-rated health in this cross-sectional study. Future research needs to address the specific importance of strain in domestic work as a contributory factor to women's ill-health.

Place, publisher, year, edition, pages
London: Sage Publications, 2008
Keyword
Domestic work, Self-rated health, Strain, Women
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-21097 (URN)10.1177/1403494807085307 (DOI)000253267700004 ()18426781 (PubMedID)2-s2.0-42449107304 (Scopus ID)
Available from: 2013-01-15 Created: 2013-01-15 Last updated: 2017-02-14Bibliographically approved
2. Exploring consequences of sickness absence - a longitudinal study on changes in self-rated physical health
Open this publication in new window or tab >>Exploring consequences of sickness absence - a longitudinal study on changes in self-rated physical health
2009 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 34, no 3, 315-324 p.Article in journal (Refereed) Published
Abstract [en]

Women experience sickness absence more often than men, but few studies have addressed the possibility that the sick-leave period itself could be regarded as an exposure with possible positive or negative consequences on health. The aim was to explore the association between experience of sickness absence and self-rated physical health. Interview data from population samples in 1990 and 1995 of women born in 1935, 1945, 1955 and 1965 (n=231) were used. 'Any sick-leave' and 'Long sick-leave' were used as exposure measures and analyzed in relation to change in self-rated physical health with multivariate logistic regression, adjusting for age and prior sickness absence. Separate analyses were performed for women with psychiatric disorders (DSM-III-R) and different level of domestic responsibility. The proportion reporting good health at baseline and follow up were lower when experienced sickness absence compared to those who had not. For women exposed to long sick-leave, the OR for remained poor health were 4.1 (95% CI 1.1-15.4), and for women with psychiatric disorders, the OR for a change from poor to good health was 9.9 (1.7-58.5). Women with high level of domestic responsibility and exposed to long sick-leave, had increased ORs for both a positive and negative change in health. This explorative study contributes to the sparse knowledge of consequences on health of sickness absence. © 2009 - IOS Press and the authors. All rights reserved.

Place, publisher, year, edition, pages
Amsterdam: IOS Press, 2009
Keyword
Consequences, Domestic responsibility, Psychiatric disorders, Sickness absence, Women
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-21093 (URN)10.3233/WOR-2009-0929 (DOI)000273753600008 ()2-s2.0-77449132930 (Scopus ID)
Available from: 2013-01-15 Created: 2013-01-15 Last updated: 2017-02-14Bibliographically approved

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