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Combining work and informal care giving by older workers: does this increase gender-related health inequalities?

Projectomschrijving

1 op de 4 werknemers combineert werk en mantelzorg. Mantelzorg geven kan zorgen voor stress en depressieve gevoelens, zeker in combinatie met betaald werk. Omdat mannen en vrouwen vaak ander werk hebben, en vrouwen meer mantelzorg geven dan mannen, kan dit leiden tot gezondheidsverschillen tussen mannen en vrouwen.

Doel

We onderzochten of werkende mantelzorgers meer last krijgen van depressieve klachten dan werknemers zonder mantelzorgtaken. En vervolgens bekeken we de rol van werk en leefstijl en de verschillen tussen mannen en vrouwen.

Resultaten

Mannen verlenen minder vaak mantelzorg dan vrouwen, maar wanneer ze mantelzorg verlenen, zijn er geen verschillen met vrouwen in depressieve klachten. Sociale steun op het werk kan beschermen tegen depressieve klachten bij mantelzorgers. Meer autonomie in het werk helpt ook, maar vooral bij mannen. Emotionele belasting in werk is een risicofactor voor depressieve klachten bij werkende mantelzorgers. Leefstijl speelt hier geen rol in.

Verslagen


Eindverslag

Een op de vier werknemers combineert werk en mantelzorg. Mantelzorg geven kan zorgen voor stress en depressieve gevoelens, zeker in combinatie met betaald werk. Omdat mannen en vrouwen vaak ander werk hebben, en vrouwen meer mantelzorg geven dan mannen, kan dit leiden tot gezondheidsverschillen tussen mannen en vrouwen. We onderzochten of werkende mantelzorgers meer last krijgen van depressieve klachten dan werknemers zonder mantelzorgtaken en welke rol werk en leefstijl hierbij spelen bij mannen en vrouwen. Mannen verlenen minder vaak mantelzorg dan vrouwen, maar als ze mantelzorg verlenen, zijn er geen verschillen met vrouwen in depressieve klachten. Sociale steun op het werk kan beschermen tegen depressieve klachten bij mantelzorgers. Meer autonomie in het werk helpt ook, maar vooral bij mannen. Emotionele belasting in werk is een risicofactor voor depressieve klachten bij werkende mantelzorgers. Leefstijl speelt hier geen rol in.

Samenvatting van de aanvraag

GENDER DIFFERENCES IN HEALTH Women more often suffer from common mental problems compared to men, in particular women aged 45-65 years. This may be caused by informal care giving (e.g. providing help to health-impaired kin or non-kin) as this is most prevalent among women in this age group, and because women experience a higher mental health burden by informal care giving than men, as was shown in cross-sectional studies. Using a longitudinal approach, we will study if the combination of informal care giving and work, increases gender inequalities in mental health. Additionally, we will investigate explanations for these gender inequalities by exploring gender-related differences in work characteristics and lifestyle behaviours. Mental health outcomes of informal care giving have been associated with working conditions that differ between men and women (e.g., working hours, autonomy, support at work), but lacked study of a gender perspective. Moreover, time constraints and worries resulting from combining work with informal caregiving may yield unhealthy lifestyle habits (e.g., more alcohol, less time for sports activities) that may differ between women and men. These innovative pathways have never been examined before. INTERSECTIONALITY: DOUBLE BURDEN FOR THOSE IN LOWER SOCIO-ECONOMIC POSITION (SEP)? Considering the poorer health status of low SEP groups, it is important to gain insight into the potential double vulnerability of women in lower socio-economic groups that combine informal care giving with paid work. Larger gender differences in mental health are expected in lower socio-economic groups. MAIN RESEARCH QUESTION: Does informal care giving increase gender-related health inequalities in older workers and how does this differ by low and higher socio-economic position? Secondary research question: Do working conditions or lifestyle behaviour explain these gender-related health inequalities? OPERATIONALISATION OF GENDER This proposal focuses on gender differences as we focus on structural and cultural explanations for differences between men and women in informal care giving, work characteristics and lifestyle behaviour. We do not focus on sex differences as we do not expect a biological or genetic routing that would provide insight into sex differences. By focussing on gender-sensitive determinants between men and women, we aim to gain insight into gender as structural difference related to work context (choices of women to work in healthcare or education) and as sociocultural difference related to informal care giving (societal expectations regarding women as caregiver) and lifestyle behaviour (preference of women for health in general and healthy habits in particular). DATASETS Two existing longitudinal datasets of large Dutch cohort studies are used, both including a group of older (45+ years) workers, and data on informal care giving and mental health. 1) STREAM: Study on Transitions in Employment, Ability and Motivation: working conditions (5 measurements between 2010-2015). 2) DCS: Doetinchem Cohort Study: lifestyle behaviour (1 measurement, 5-year follow up). By using two data-sets, we will be able to 1) externally validate our findings, and 2) explore the explanatory role of working conditions in STREAM, and the role of lifestyle behaviour in DCS. Our study population consists of workers aged 45 years and up, involved in paid work. Perceived mental health is our main outcome measure (CESD12). Informal care giving is defined as providing unpaid help to a significant other (spouse, parent, other kin, non-kin) who suffers from health problems. High and low socio-economic groups are defined based on highest level of completed education. ANALYSES For the main research question, we will perform trend analyses and test the effects of informal care giving on changes in mental health over a 5-year period among male and female workers, separately for high and low socio-economic groups in STREAM. We will validate these findings by performing similar analyses in DCS. For the secondary research question, we will test if working conditions explain the effects of informal care giving on changes in mental health in male and female workers in STREAM. In DCS, we will test if lifestyle behaviour explains the effect of informal care giving on changes in mental health in male and female workers. TARGET GROUP/ STAKEHOLDER PARTICIPATION & DISSEMINATION The target group consists of workers aged 45+ years with informal care giving tasks. This proposal is a joint effort of scientists, 1 knowledge partner (Movisie), 1 target group representative (Mezzo) and 2 target group members (1 male and 1 female workers with informal care giving tasks) who will collaborate throughout the project. This collaboration is crucial to make sure that this project will lead to directions for relevant interventions to reduce gender-related mental health inequalities in older workers in the context of socio-economic health inequalities.

Kenmerken

Projectnummer:
849500006
Looptijd: 100%
Looptijd: 100 %
2018
2019
Onderdeel van programma:
Gerelateerde subsidieronde:
Projectleider en penvoerder:
Prof. dr. C.R.L. Boot
Verantwoordelijke organisatie:
Amsterdam UMC - locatie VUmc