Gender sensitive aspects of occupational health analysis and health promotion Prof. Dr. Antje Ducki Dublin, June 15th, 2014

Picture source: http://t2.gstatic.com/images?q=tbn:ANd9GcSz7uXgGBgVD_c1wy7u8yO5JNwRn1m2LFsk0TdyDOJJBgNjCaw5JAziDXo

Structure 1. Gender segregation of work and health 2.

An example for gender-specific health analysis and health promotion 2.1 Special conditions in public administrations 2.2 The Study  Objectives  Methods  Results 2.3 Consequences for gender-sensitive intervention

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1. Gender segregation of work and health

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Gender differences in paid employment Employment rate in EU 2011 (Aged 20-64, in %)

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Source: Destatis 2012

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Continously increase of female employment Percentage of women of all employees in Germany

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Source: Destatis 2012/13

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Gender differences in labour contracts 100% 86%

90%

78%

80% 70% 60%

52%

50% 40%

67%

64% 48%

35%

34%

30%

33% 22%

20%

14%

10%

10% 0%

befristet fixed-duration Beschäftigte jobs

Teilzeitbeschäftigte part-time jobs

geringfügig Zeitarbeitende mini jobs temporary work Beschäftigte (under €450/month) (temp job) Source (mod. statista, 2012a) .

Insgesamt

Frauen

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Männer

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Gender differences in skilled work

Number of apprenticeship contracts

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Source: Statista 2011

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Gender differences in courses of study Choice of course of studies (1991-2012)

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Source: DSW/ HIS 2012

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Gender differences in technical courses of Beuth HS

Department VII: Mechanical Engineering, Process and Environmental Technology

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Different wages: The Gender Pay Gap

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Source: Destatis 2012

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Gender differences in positions Dax 30: Board of directors / CEO‘s with women on the board

Total

30

30

30

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30

30

30

Source: DIW Berlin 2013

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Different positions Dax 30: Supervisory board

Total

527

513

502

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479

494

489 Source: DIW Berlin 2013

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Different responsibilities for housework

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Source: Ruhr Economic Papers 2014

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Summary: Gender differences in work

Gender segregation of work still exists

 Women and men choose different occupations  They hold different positions

 They earn different wages for the same work  Their responsibilities for housework and family are different Picture source:http://www.leftfootforward.org/images/2013/12/Gender-segregation1-300x210.png

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Health consequences of gender segregation

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Health consequences of gender segregation  Specific forms of discrimination

 Gender-specific stressor/resource constellations within the job

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http://www.the guardian.com

Stressors of man and women

Labour fources working in full-time

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Source: baua 2013

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Resources of man and women Task related and social resources in %

N=8089

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N=9473

Source: Baua 2012

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Health consequences of gender segregation

 Specific forms of discrimination  Gender-specific stressor/resource constellations within the job  Specific recovery opportunities  Variations in health behaviour  Gender-specific health effects

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(picture source: BKK Gesundheitsreport 2014)

Occupational diseases Distribution of occupational diseases in Germany from 1992-2010 (in %) Women

Men

Chemical influences

Physical influences Infections/ Parasites/ tropical disease Airway-/lung-/ disease/Peritonitis Dermatosis Other causes

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Source: WSI Gender Portal 2013

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Absenteeism days In % 11 Männer Men

Frauen Women

10 9 8 7 6 5 4 3 2 1

0 Frauen Women Men Männer

15–19 3,4 3,6

20–24 3,5 3,8

25–29 3,1 3,4

30–34 3,1 3,5

35–39 3,8 4,0

40–44 4,7 4,5

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45–49 5,4 5,1

50–54 6,3 6,1

55–59 7,4 7,6

60–64 8,0 9,1

Source: Badura et al. 2013

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Absenteeism days in selected sectors

sex and age standardized absence days/year

women

man 10,4

18,2

14,6

15,6

garbage dispoasal

18,3

carrying/teaching

public administration

14,2 15,4

10,4

14,1 12,1

17,3 16,4 16,8

20,6

Female dominated sectors

16,7

Health care

Male dominated sectors

building trades

whole

Source: BKK Gesundheitsreport 2013

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Gender differences in diseases Tage in %

100%

Fälle in % Sonstige others Verdauung Gastro intenstinal d.

29,6 80%

34,4

30,7

Heart diseases Herz/Kreislauf

36,8

Mental disorders Psyche Respiratory diseases Atemwege Occ. accidents Verletzungen

5,8 60%

7,5

5,2 5,3

7,6

10,3 4,4 4,0

13,3 10,9 40%

Musculosceletal Muskel/Skelett

9,9

diseasess

3,9 6,3

20,9 12,2 22,7

14,4 8,3

10,5

20%

5,9

24,2

21,3

19,2

14,5

0% man Männer

women Frauen

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man Männer

women Frauen

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Summary: Gender differences in work and health

Gender segregation of work leads to different health consequences and health outcomes. These differences must be considered in a gender-sensitive analysis and in the interpretation of the results.

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An example for gendersensitive analysis and health promotion in public administrations

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Specific conditions in public administrations Job characteristics in public administrations  Office work means working with information  Mainly sedentary work at the computer  High increase in work intensity  Restructuring: new public management Health aspects in public administrations  Higher average age  Greatest number of staff on sick leave in comparison to the German average  Mental disorders have doubled in the last ten years Gender aspects in public administrations  Half of the employees in state employment in Berlin are female  13% of women are represented in the senior levels but 22% of men  The absenteeism days of women are higher than the absenteeism days of men (8. Gendermainstreaming report for Berlin, 2006; Badura et al. 2007; Küsgens, Macco Vetter, 2008)

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Work and Health survey‘s in Berlin‘s senate administrations 2010 - 2014

18,212 employees surveyed 9,544 answers

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total response rate: 52,4% response range from 39% to 79%

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The Pilot study Aim 

investigate gender-specific differences in the working conditions and health outcomes of public civil servants to get detailed information for a gender-specific intervention approach

Methods 

self-administered questionnaire



stressors, resources and different health outcomes (DiGA instrument, Ducki, 2000)



reliability and validity of the instrument are good or sufficient.



Response: 38%

Sample 

136 female and 132 male civil servants



age: 74% are over 40



working Time: 17% are working part-time



family duties: 40 % have children to look after, 6% look after other people



significant gender differences: women lower salary, less leadership function and more part time work

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Results: Stressors women (n= 136)

men (n=132)

Mean

Standarddeviation

Mean

Standarddeviation

Time pressure

3.5

1.2

3.6

0.9

Interruptions by persons

3.4

1.1

3.4

1,0

One-sided physical strains

3.1

1.1

2.6

1,1

Customer-related stressors

2.0

0.9

2.2

0,8

Information deficits

2.1

0.8

2.4

0.9

Environmental stressors

2.0

0.7

1.9

0.7

Interruptions due to inadequate equipment*

1.8

0.8

2.1

1.0

IT stressors*

1.6

0.7

2.0

0.9

Restructuring stressors

1.5

0.8

1.7

0.9

Bullying

1.3

0.7

1.2

0.5

5-point scale from 1 = not at all to 5 = completely agree

* = significant gender differences: women mention significantly fewer stressors than men! (T- test for independent samples; p=.05) Beuth Hochschule für Technik Berlin – University of Applied Sciences

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Results: Resources women

men

Mean

Standarddeviation

Mean

Standarddeviation

Work-Life balance

3.9

0.7

3.8

0.8

Task variability

3.8

0.9

3.9

0.8

Decision latitude

3.8

0.7

3.7

0.7

Appreciation

3.7

0.9

3.7

1.0

Communication at the workplace**

3.6

0.9

4.0

0.8

Development opportunities at work

3.3

1.2

3.1

1.2

Participation

3.0

1,0

3.1

1.1

Transparency

3.4

0.9

3.4

1.0

Positive health behaviour

3,4

1.0

3,4

0.9

5-point scale from 1 = not at all to 5 = completely agree

** significant gender differences: communication at the workplace is valued more highly by men (T- test for independent samples; p=.001) Beuth Hochschule für Technik Berlin – University of Applied Sciences

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Results: Health women

men

5-point scale from 1 = not at all to 5 = completely agree or 4-point scale from 1 = never to 4 = very often

mean

Standarddeviation

mean

Standarddeviation

Enjoyment of work

3.8

0.7

3.8

0.7

Job satisfaction

3.6

0.9

3.6

0.9

Psychosomatic disorders*

2.3

0.8

2.0

0.8

Somatic disorders**

2.2

0.7

1.9

0.6

Irritation*

2.1

0.7

2.0

0.6

*, ** = significant gender differences: women have significantly stronger disorders than men! (T- test for independent samples; * p=.05 ** p=.001)

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Gender differences in the correlations between working conditions and health Stronger correlations between the individual work chararacteristics and disorders Psychosomatic disorders

Somatic disorders

Irritation

women

men

women

men

women

-.37

-.13

-.40

-.21

-.11

Development opportunities

-.25

-.15

-.39

-.17

-.15

-.05

Communication

-.50

-.24

-.40

-.23

-.32

-.33

Participation

-.37

-.12

-.38

-.23

-.23

-.15

Transparency

-.41

-.11

-.38

-.19

-.38

-.19

Appreciation

-.34

-.23

-.35

-.17

-.35

-.21

Work-life-balance Work-life balance

-.43

-.13

-.50

-.29

-.38

-.17

Information deficits

.36

.08

.28

.17

.39

.13

.43

.20

.32

.13

.24

.27

Task variability

Bullying

Men

.00

bold: correlation difference is significant (Preacher, 2002). Beuth Hochschule für Technik Berlin – University of Applied Sciences

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Regression analyses Dependent variable: Disorder Index

N = 136

Model

Predictors/Resources

R

R2

Beta -.35

Sig. .000

.59

.35

-.32

.000

R

R2

Beta

.51

.26

Sig. .000 .000

R

R2

decision latitude

.51

.26

Predictors/stressors

R

work-life balance 2 Model

communication Predictors/stressors

bullying 2

Model

N = 132

information deficits

Predictors/resources

Model

one-sided physical strains 2

restructuring stressors

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.47

.31

Beta

Sig.

-,38

.000

-.32

.000

R2

Beta

Sig.

.22

.39

.000

.20

.001

health behaviour 2

.31

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Conclusion: Main intervention points For women and men interventions should be developed for the reduction of the following: 1. time pressure 2. one-sided physical strains and 3. interruptions by persons In addition to the general changes gender-specific interventions should focus on •

work-life balance

•

communication

•

bullying

•

information deficits

• • • •

health behaviour decision latitude one-sided strains restructuring stressors

The decision which interventions may be suitable must be developed together with the employees at their place of work, since each department has its own causes of these stressors.

Gender-sensitive Health Promotion Gender-sensitive organisation  check processes for gender effects  gender-mixed composition of steering groups, decision-making committees, circles  provide actors with gender qualifications Gender-sensitive analysis  gender as a category in socio-demographic questions  take gender differentiated situations, stressors and resources into account.  be generally gender-neutral in one‘s formulations. Gender-sensitive intervention  working hours: allow the co-ordination of work and family  design health programmes in a gender-sensitive way:  make a conscious decision in favour of mixed gender or gender separated health circles  consider family needs and requirements in the scheduling of programmes  gender-sensitive methodology:  women: verbal exchange of ideas during training programmes is important.  men: practical stress reduction programmes (exercises), make them aware of check-ups, organise exercise programmes in such a way that they are not embarrassing. Gender-sensitive evaluation  evaluate gender differences in the impacts of interventions.

Conclusion

Gender sensitivity does not make practical preventive work simpler, but hopefully it can make interventions more appropriate to target groups and thus more effective.

Thank you for your attention!

Literature 

Ducki, A., Hoppe, A.K. & Stade, J.C. (Hrsg.). (in prep.). Prekäre Beschäftigung im Niedriglohnsektor – gesundheitliche Relevanz vor dem Hintergrund geschlechtsspezifischer Belastungen und –Ressourcen.



Ducki, A., Hlawatsch, A., Siebert, M.M., Voshage, R. (2014). Befragungen der Mitarbeiterinnen und Mitarbeiter zum Thema Arbeit und Gesundheit in der Berliner Verwaltung. In: Zeitschrift für amtliche Statistik Berlin Brandenburg, 6, 2013, S. 50-55. ISSN: 1864-5356

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Babitsch, B., Ducki, A. & Maschewsky-Schneider, U. (2012). Geschlecht und Gesundheit. In K. Hurrelmann & O. Razum (Hrsg.), Handbuch Gesundheitswissenschaften (S. 639660). Weinheim: Belz Juventa.

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Ducki, A. (2011). Gendersensible betriebliche Gesundheitsförderung. In E. Bamberg, A. Ducki & A.M. Metz (Hrsg.), Gesundheitsförderung und Gesundheitsmanagement in der Arbeitswelt. Ein Handbuch (S. 439-461). Göttingen: Hogrefe.

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Aust, B. & Ducki, A. (2004). Beyond individual behavior change toward workplace intervention. Experiences from Germany. Journal of Occupational Health Psychology, 9(3), 258-270.

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Ducki A. & Maschewsky-Schneider U. (2003). Germany: Women, health and work – Main findings of the first federal report on women’s health. In L. Vogel (Ed.), The gender workplace gap in Europe (pp. 213-223). Bruxelles: TUTB.

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