Dear Colleagues

Attached below information on some papers from the latest issue of Social Science and Medicine which may be of interest to you. 

David McDaid
LSE Health and Social Care

Journal: Social Science and Medicine
ISSN   : 0277-9536
Volume : 54
Issue  : 4
Date   : Feb-2002


The contribution of gender-role orientation, work factors and home
stressors to psychological well-being and sickness absence in male-
and female-dominated occupational groups
O. Evans, A. Steptoe
pp 481-492

Abstract

The associations of work stress, types of work and gender-role orientation with psychological well-being and sickness absence
were investigated in a questionnaire survey of 588 male and female nurses and 387 male and female accountants. We
hypothesised that health might be impaired among women working in the male-dominated occupation (accountancy), and men in
the female-dominated occupation (nursing), but that effects might be moderated by job strain (perceptions of high demand and low
control), work and home hassles, and traditional male (instrumentality) and female (expressivity) psychological characteristics.
Responses were analysed from 172 female and 61 male nurses, and from 53 female and 81 male commercial accountants. Female
accountants were more likely than other groups to have high anxiety scores on the Hospital Anxiety and Depression Scales, while
male nurses had the highest rates of sickness absence. Male nurses and female accountants also reported more work-related
hassles than did female nurses and male accountants. Men and women in the same occupation did not differ in job strain or job
social support, but nurses reported greater job strain than accountants, due to higher ratings of demands and lower skill utilisation.
After adjusting for age, sex, occupation, paid work hours and a measure of social desirability bias, risk of elevated anxiety was
independently associated with higher job strain, lower job social support, more work hassles, more domestic responsibility, lower
instrumentality and higher expressivity. The association between sex and anxiety was no longer significant after instrumentality
had been entered into the regression model. Sickness absence of more than three days over the past 12 months was independently
associated with higher job strain, more work hassles, lower instrumentality and higher expressivity. The results suggest that when
men and women occupy jobs in which they are in the cultural and numerical minority, there may be adverse health effects that are
gender-specific. Psychological traits related to socially constructed gender roles may also be relevant, and mediate in part the
differences in psychological well-being between men and women. 

Inequalities in the transition of cerebrovascular disease mortality
in New South Wales, Australia 1969-1996
I.H. Burnley, D. Rintoul
pp 545-559

With reference to epidemiological transition theory, this paper examines change in cerebrovascular disease mortality in Australia's
most populous state in the 28 year period, 1969¯1996. The hypotheses were that in the context of overall stroke mortality decline
over the period, marital status, occupational status and spatial differences decreased. However, while overall mortality declined,
differentials increased. The reasons for this are considered, with particular implications for epidemiological transition theory and
for the targeting of populations at risk in policy terms. 


Letting the Gini out of the bottle? Challenges facing the relative
income hypothesis
G.T.H. Ellison
pp 561-576

Abstract

The relative income hypothesis interprets statistical associations between income inequality and average health status at the
population level, as evidence that income inequality has a deleterious psychosocial effect on individual health. An alternative
explanation is that these, population-level associations, are statistical artefacts of curvilinear, individual-level relationships between
income and health. Indeed, provided the cost¯benefit ratio of health-enhancing goods and services vary, the law of diminishing
returns should produce curvilinear, asymptotic relationships between income and health at the individual level, which create
(`artefactual') associations between income inequality and health at the population level. However, proponents of the relative
income hypothesis have argued that these relationships are unlikely to be responsible for the associations observed between
income inequality and average health status amongst high-income populations. In these populations, the individual-level
relationships between income and health would be nearer their asymptotes, where a shallower slope should ensure that income
inequality has little (if any) `artefactual' effect on average health status. Yet this argument was based on analyses of
population-level data which underestimated the slope and curvilinearity of underlying, individual-level relationships between income
and health. It is therefore likely that (at least some part of) the population-level associations between income inequality and
average health status (amongst low-, middle- and high-income populations) are `artefacts' of curvilinear, individual-level
relationships between income and health. Nevertheless, it is also possible that income inequality is somehow (partly or wholly)
responsible for the curvilinear nature of individual-level relationships between income and health. Likewise, it is possible that
income inequality alters the height, slope and/or curvilinearity of these relationships in such a way that income inequality has an
independent effect on individual health. In either instance, the `artefactual' effect of curvilinear relationships between income and
health at the individual level would simply reflect the mechanism underlying the relative income hypothesis. 

Income, income inequality and health: what can we learn from
aggregate data?
H. Gravelle, J. Wildman, M. Sutton
pp 577-589

Abstract

It has been suggested that, especially in countries with high per capita income, there is an independent effect of income distribution
on the health of individuals. One source of evidence in support of this relative income hypothesis is the analysis of aggregate
cross-section data on population health, per capita income and income inequality. We examine the empirical robustness of
cross-section analyses by using a new data set to replicate and extend the methodology in a frequently cited paper. The estimated
relationship between income inequality and population health is not significant in any of our estimated models. We also argue there
are serious conceptual difficulties in using aggregate cross-sections as means of testing hypotheses about the effect of income,
and its distribution, on the health of individuals. 


Gender differences in mental health: evidence from three
organisations
C. Emslie, R. Fuhrer, K. Hunt, S. Macintyre, M. Shipley, S. Stansfeld
pp 621-624

Abstract

It is commonly observed that women report higher levels of minor psychiatric morbidity than men. However, most research fails to
control for the gendered distribution of social roles (e.g. paid work and domestic work) and so does not compare men and women
in similar positions. In this short report, we examine the distribution of minor psychiatric morbidity (measured by the 12 item
General Health Questionnaire) amongst men and women working in similar jobs within three white-collar organisations in Britain,
after controlling for domestic and socioeconomic circumstances. Data from self-completion questionnaires were collected in a
Bank (n=2176), a University (n=1641) and the Civil Service (n=6171). In all three organisations women had higher levels of minor
psychiatric morbidity than men, but the differences were not great; in only the Civil Service sample did this reach statistical
significance. We conclude that generalisations about gender differences in minor psychiatric morbidity can be unhelpful, as these
differences may vary depending on the context of the study. 


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