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Gender (in)equality among employees in elder care: implications for health
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
2012 (English)In: International Journal for Equity in Health, ISSN 1475-9276, Vol. 11, no 1Article in journal (Refereed) Published
Abstract [en]

Introduction: Gendered practices of working life create gender inequalities through horizontal and vertical gender segregation in work, which may lead to inequalities in health between women and men. Gender equality could therefore be a key element of health equity in working life. Our aim was to analyze what gender (in) equality means for the employees at a woman-dominated workplace and discuss possible implications for health experiences.

Methods: All caregiving staff at two workplaces in elder care within a municipality in the north of Sweden were invited to participate in the study. Forty-five employees participated, 38 women and 7 men. Seven focus group discussions were performed and led by a moderator. Qualitative content analysis was used to analyze the focus groups.

Results: We identified two themes. "Advocating gender equality in principle" showed how gender (in) equality was seen as a structural issue not connected to the individual health experiences. "Justifying inequality with individualism" showed how the caregivers focused on personalities and interests as a justification of gender inequalities in work division. The justification of gender inequality resulted in a gendered work division which may be related to health inequalities between women and men. Gender inequalities in work division were primarily understood in terms of personality and interests and not in terms of gender.

Conclusion: The health experience of the participants was affected by gender (in) equality in terms of a gendered work division. However, the participants did not see the gendered work division as a gender equality issue. Gender perspectives are needed to improve the health of the employees at the workplaces through shifting from individual to structural solutions. A healthy-setting approach considering gender relations is needed to achieve gender equality and fairness in health status between women and men.

Place, publisher, year, edition, pages
BioMed Central, 2012. Vol. 11, no 1
Keyword [en]
Content analysis, focus groups, gender, health experiences, work environment, workplace
National Category
Family Medicine
URN: urn:nbn:se:umu:diva-54342DOI: 10.1186/1475-9276-11-1ISI: 000300877300001OAI: diva2:518646
Available from: 2012-04-24 Created: 2012-04-24 Last updated: 2013-05-24Bibliographically approved
In thesis
1. Gender equality and health experiences: workplace patterns in Northern Sweden
Open this publication in new window or tab >>Gender equality and health experiences: workplace patterns in Northern Sweden
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Jämställdhet och hälsoupplevelser : arbetsplatsmönster i norra Sverige
Abstract [en]

Gendered practices of working life create gender inequalities through horizontal and vertical gender segregation in work, which may lead to gender inequalities in health experiences. The workplace is an important part of the social circumstances under which health opportunities and constraints are shaped. The workplace has also been identified as an important arena for gender constructions. Still, there is a lack of research about the relations between workplace gender equality and health experiences. The aim of this thesis was to explore gender equality and health experiences in a workplace setting.

Qualitative and quantitative methods were used. In the qualitative studies all caregiving staff at two establishments providing care for elderly was invited to participate in focus groups (Papers I & II). A moderator led 14 focusgroup discussions. Qualitative content analysis was used to analyse the transcribed discussions. For the quantitative studies questionnaire data from the Northern Swedish Cohort (n=836) were analysed and supplemented with register data about the participants’ workplaces. The register data were used to stratify the workplaces according to gender composition (paper IV) and to create gender equality indicators of the number of women and men at the workplace, education, salary and parental leave (Paper III). Cluster analysis was used to identify patterns of gender equality at the workplaces. Logistic regression analysis, adjusting for individual socio-demographics and previous psychological distress, were used to analyse psychological distress in relation to both clusters and gender compositions.

This thesis identifies various workplace patterns of gender equality and how they are related to health experiences. The results from the focus group study showed that workplace stressors had a structural character, often originating from societal processes outside the own organization, whereas health resources had a relational character and were constructed within the organization (paper I). Gender equality was seen as a structural issue not connected to the individual health experiences and gender inequalities were justified through focusing on personalities and interests in work division (paper II). The cluster analysis resulted in six distinctive clusters with different workplace patterns of gender equality (paper III). The most gender-equal cluster was characterized by gender equality in salary and parental leave and was associated with the lowest prevalence of psychological distress, with no significant differences between women and men. The clusters were associated with psychological distress among women only. The highest odds for psychological distress among women were found in a traditional unequal cluster. Analyses of the gender composition at the workplace showed that the highest prevalence of psychological distress was found at workplaces with a mixed gender composition (paper IV). The psychosocial work environment was rather similar independent of the workplace gender composition.The factors most strongly associated with psychological distress were high demands and low control at workplaces with more men, being looked down upon at workplaces with a mixed gender composition, and social support at workplaces with more women.

Gender perspectives highlight the importance of gender relations in research on work-related health. Gender inequalities at workplaces can be part of the explanation to women’s worse self-rated health. A multidimensional view of gender equality is necessary to understand health consequences of specific workplace situations. Workplaces are important arenas for health promotion activities and gender equality aspects needs to be taken into account to reach both women and men. Adequate health promotion needs to shift focus from individual health strategies to structural solutions that can challenge the root of the problem.

Abstract [sv]

Ojämställdhet i arbetslivet kan innebära olika hälsokonsekvenser för kvinnor och män. Arbetsplatsen är en viktig del av de sociala omständigheter under vilka hälsomöjligheter och -begränsningar skapas. Arbetsplatsen har också identifierats som en viktig arena för genuskonstruktioner. Trots detta saknas forskning om relationerna mellan jämställdhet på arbetsplatser och hälsoupplevelser. Den här avhandlingen syftar till att studera sambanden mellan jämställdhet på arbetsplatser och de anställdas hälsoupplevelser.

Avhandlingen använder både kvalitativa och kvantitativa metoder. I de kvalitativa studierna erbjöds all vårdpersonal på två äldreboenden att delta i fokusgruppsdiskussioner (Artikel I & II). Sammanlagt genomfördes 14 fokusgrupper. Kvalitativ innehållsanalys användes för att analysera de transkriberade fokusgrupperna. I de kvantitativa studierna användes enkätdata från Luleåkohorten(n= 836) som kompletterats med registerdata om deltagarnas arbetsplatser. Registerdata användes för att stratifiera deltagarna utifrån könssammansättningen på deras arbetsplatser (artikel IV) och för att skapa jämställdhetsindikatorer för arbetsplatserna vad gäller andel män och kvinnor, utbildningsnivå, lön och föräldraledighet (artikel III). Klusteranalys användes för att identifiera mönster av jämställhet på arbetsplatserna. Skillnader i psykiska besvär mellan klustren respektive de olika könssammansättningarna analyserades med logistisk regressionsanalys som justerats för sociodemografiska variabler och tidigare psykiska besvär.

Avhandlingen identifierar olika jämställdhetsmönster på arbetsplatsenoch hur de är relaterade till hälsoupplevelser. Resultaten från fokusgruppstudierna visade att de hälsorelaterade stressorerna hade en strukturell karaktär som ofta hade sitt ursprung i sociala processer utanför den egna organisationen. Hälsoresurserna var i hög utsträckning av relationell karaktär och skapades inom organisationen. Ojämställdhet sågs som ett strukturellt problem som inte kopplades till individuell hälsa. Ojämställdhet i arbetsfördelningen försvarades genom att fokusera på personligheter och individuella intressen. Kvantitativa analyser resulterade i sex kluster med olika jämställdhetsmönster på arbetsplatserna. Det mest jämställda klustret kännetecknades av arbetsplatser med jämställda löner och föräldraledighet och var relaterat till den lägsta förekomsten av psykiska besvär. I detta kluster hade också män och kvinnor samma förekomst av psykiska besvär. Bland kvinnorna fanns det skillnader mellan klusterna vad gäller psykiska besvär, men inte bland männen. Den högsta förekomsten av psykiska besvär bland kvinnor fanns i det traditionellt mest ojämställda klustret (artikel III) samt på arbetsplatser med en blandad könssammansättning (artikel IV). Variationen i den psykosociala arbetsmiljön var liten mellan arbetsplatser med olika könssammansättning men det fanns skillnader i sambanden mellan den psykosociala arbetsmiljön och psykiska besvär. De faktorer som hade starkast samband med psykiska besvär var höga krav och låg kontroll på arbetsplatser med en majoritet män, att bli ”sedd ner på” på könsblandade arbetsplatser, och socialt stöd på arbetsplatser med en majoritet kvinnor.

Genusperspektiv är viktiga för att lyfta fram betydelsen av genusrelationer i forskning om arbetsrelaterad hälsa. Ojämställdhet på arbetsplatser kan vara en del av förklaringen till kvinnors sämre självskattade hälsa. En mångdimensionell syn på jämställdhet är nödvändig för att förstå hälsokonsekvenser av specifika arbetsplatssituationer. Arbetsplatser utgör också viktiga arenor för hälsofrämjande åtgärder och jämställdhetsaspekter måste beaktas för att dessa åtgärder ska nå både kvinnor och män på arbetsplatserna. Hälsofrämjande arbete måste skifta fokus från individuella, beteendeinriktade hälsostrategier till strukturella lösningar som kan utmana grunden till problemen.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2013. 66 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1542
gender equality, workplace, health experiences, focus groups, cluster analysis, gender, work environment, gender regimes
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
urn:nbn:se:umu:diva-63973 (URN)978-91-7459-542-0 (ISBN)
Public defence
2013-02-01, sal 135, byggnad 9A, målpunkt X, Norrlands universitetssjukhus, Umeå, 09:00 (Swedish)
FAS, Swedish Council for Working Life and Social Research, Dnr 2007-2073Vinnova
Available from: 2013-01-11 Created: 2013-01-09 Last updated: 2013-01-11Bibliographically approved

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