Effort-reward imbalance at work and the co-occurrence of lifestyle risk factors: cross-sectional survey in a sample of 36,127 public sector employees

Background In occupational life, a mismatch between high expenditure of effort and receiving few rewards may promote the co-occurrence of lifestyle risk factors, however, there is insufficient evidence to support or refute this hypothesis. The aim of this study is to examine the extent to which the dimensions of the Effort-Reward Imbalance (ERI) model – effort, rewards and ERI – are associated with the co-occurrence of lifestyle risk factors. Methods Based on data from the Finnish Public Sector Study, cross-sectional analyses were performed for 28,894 women and 7233 men. ERI was conceptualized as a ratio of effort and rewards. To control for individual differences in response styles, such as a personal disposition to answer negatively to questionnaires, occupational and organizational -level ecological ERI scores were constructed in addition to individual-level ERI scores. Risk factors included current smoking, heavy drinking, body mass index ≥25 kg/m2, and physical inactivity. Multinomial logistic regression models were used to estimate the likelihood of having one risk factor, two risk factors, and three or four risk factors. The associations between ERI and single risk factors were explored using binary logistic regression models. Results After adjustment for age, socioeconomic position, marital status, and type of job contract, women and men with high ecological ERI were 40% more likely to have simultaneously ≥3 lifestyle risk factors (vs. 0 risk factors) compared with their counterparts with low ERI. When examined separately, both low ecological effort and low ecological rewards were also associated with an elevated prevalence of risk factor co-occurrence. The results obtained with the individual-level scores were in the same direction. The associations of ecological ERI with single risk factors were generally less marked than the associations with the co-occurrence of risk factors. Conclusion This study suggests that a high ratio of occupational efforts relative to rewards may be associated with an elevated risk of having multiple lifestyle risk factors. However, an unexpected association between low effort and a higher likelihood of risk factor co-occurrence as well as the absence of data on overcommitment (and thereby a lack of full test of the ERI model) warrant caution in regard to the extent to which the entire ERI model is supported by our evidence.

Emerging Gender Regimes and Policies for Gender Equality in a Wider Europe

This article addresses some implications for gender equality and gender policy at European and national levels of transformations in family, economy and polity, which challenge gender regimes across Europe. Women’s labour market participation in the west and the collapse of communism in the east have undermined the systems and assumptions of western male breadwinner and dual worker models of central and eastern Europe. Political reworking of the work/welfare relationship into active welfare has individualised responsibility. Individualisation is a key trend west − and in some respects east − and challenges the structures that supported care in state and family. The links that joined men to women, cash to care, incomes to carers have all been fractured. The article will argue that care work and unpaid care workers are both casualties of these developments. Social, political and economic changes have not been matched by the development of new gender models at the national level. And while EU gender policy has been admired as the most innovative aspect of its social policy, gender equality is far from achieved: women’s incomes across Europe are well below men’s; policies for supporting unpaid care work have developed modestly compared with labour market activation policies.Enlargement brings new challenges as it draws together gender regimes with contrasting histories and trajectories. The article will map social policies for gender equality across the key elements of gender regimes – paid work, care work, income, time and voice – and discuss the nature of a model of gender equality that would bring gender equality across these. It analyses ideas about a dual earner–dual carer model, in the Dutch combination scenario and ‘universal caregiver’ models, at household and civil society levels. These offer a starting point for a model in which paid and unpaid work are equally valued and equally shared between men and women, but we argue that a citizenship model, in which paid and unpaid work obligations are underpinned by social rights, is more likely to achieve gender equality.