title: Linking credentialed skills, social class, working conditions and self-reported health: a focus on health inequality-generating mechanisms.
abstract: In this study, focus is on the mechanisms linking credentialed skills and social class relations to five dimensions of occupational stressors and three self-reported health outcomes: persistent fatigue, musculoskeletal complaints and emotional wellbeing. We test for direct health associations of skills/class. Moreover, indirect health associations of skills/class, through differential exposure to occupational stressors and effect modifications of the occupational stressors, are tested. A modified LISREL analysis is applied to a representative cross-sectional sample of 11,099 Flemish wage-earners. The direct health effects of credentialed skills/class are limited, but they are clearly indirectly related to the self-reported health outcomes through differential exposure to occupational stressors. The indirect mechanisms point to both reinforcing and moderating effects on socio-economic health inequalities. Two cases of effect modification are also observed: social class modifying the association between control and persistent fatigue; and skills affecting the association between the quality of social relations and emotional wellbeing. Differential exposure to occupational stressors is a crucial mechanism linking skills/class to socio-economic health inequalities. Direct effects and effect modification of class/skills are relevant, but of limited importance. One of the effect modifications found suggests that a specific focus on contradictory class positions might be warranted in future research.
authors.affiliation: Department of Medical Sociology, Vrije Universiteit Brussel, Belgium. cvroelen@vub.ac.be
authors.forename: Christophe
authors.initials: C
authors.lastname: Vanroelen
authors.forename: Katia
authors.initials: K
authors.lastname: Levecque
authors.forename: Guy
authors.initials: G
authors.lastname: Moors
authors.forename: Fred
authors.initials: F
authors.lastname: Louckx
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001530:Belgium / Q000453:epidemiology; D003406:Credentialing / Q000331:legislation & jurisprudence*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000453:epidemiology; D016272:Occupational Health; D011287:Prejudice; D012042:Registries; D057566:Self Report; D012923:Social Class; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult