title: Sex inequalities in physical and mental functioning of British, Finnish, and Japanese civil servants: role of job demand, control and work hours.
abstract: In general, women report more physical and mental symptoms than men. International comparisons of countries with different welfare state regimes may provide further understanding of the social determinants of sex inequalities in health. This study aims to evaluate (1) whether there are sex inequalities in health functioning as measured by the Short Form 36 (SF-36), and (2) whether work characteristics contribute to the sex inequalities in health among employees from Britain, Finland, and Japan, representing liberal, social democratic, and conservative welfare state regimes, respectively. The participants were 7340 (5122 men and 2218 women) British employees, 2297 (1638 men and 659 women) Japanese employees, and 8164 (1649 men and 6515 women) Finnish employees. All the participants were civil servants aged 40-60 years. We found that more women than men tended to have disadvantaged work characteristics (i.e. low employment grade, low job control, high job demands, and long work hours) but such sex differences were relatively smaller among employees from Finland, where more gender equal policies exist than Britain and Japan. The age-adjusted odds ratio (OR) of women for poor physical functioning was the largest for British women (OR = 2.08), followed by for Japanese women (OR = 1.72), and then for Finnish women (OR = 1.51). The age-adjusted OR of women for poor mental functioning was the largest for Japanese women (OR = 1.91), followed by for British women (OR = 1.45), and then for Finnish women (OR = 1.07). Thus, sex differences in physical and mental health was the smallest in the Finnish population. The larger the sex differences in work characteristics, the larger the sex differences in health and the reduction in the sex differences in health after adjustment for work characteristics. These results suggest that egalitarian and gender equal policies may contribute to smaller sex differences in health, through smaller differences in disadvantaged work characteristics between men and women.
authors.affiliation: Department of Welfare Promotion and Epidemiology, University of Toyama, Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, Japan. Electronic address: sekine@med.u-toyama.ac.jp.
authors.forename: Michikazu
authors.initials: M
authors.lastname: Sekine
authors.affiliation: Department of Welfare Promotion and Epidemiology, University of Toyama, Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Tatsuse
authors.affiliation: Department of Welfare Promotion and Epidemiology, University of Toyama, Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, Japan.
authors.forename: Sadanobu
authors.initials: S
authors.lastname: Kagamimori
authors.affiliation: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
authors.forename: Tarani
authors.initials: T
authors.lastname: Chandola
authors.affiliation: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
authors.forename: Noriko
authors.initials: N
authors.lastname: Cable
authors.affiliation: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Marmot
authors.affiliation: Department of Sociology, Population Research Unit, University of Helsinki, P.O. Box 18, FIN-00014 Helsinki, Finland.
authors.forename: Pekka
authors.initials: P
authors.lastname: Martikainen
authors.affiliation: Department of Public Health, University of Helsinki, P.O. Box 41, FIN-00014 Helsinki, Finland.
authors.forename: Tea
authors.initials: T
authors.lastname: Lallukka
authors.affiliation: Department of Public Health, University of Helsinki, P.O. Box 41, FIN-00014 Helsinki, Finland.
authors.forename: Ossi
authors.initials: O
authors.lastname: Rahkonen
authors.affiliation: Department of Public Health, University of Helsinki, P.O. Box 41, FIN-00014 Helsinki, Finland.
authors.forename: Eero
authors.initials: E
authors.lastname: Lahelma
mesh_terms: D000328:Adult; D003431:Cross-Cultural Comparison; D005260:Female; D005387:Finland; D054624:Health Status Disparities; D006801:Humans; D007564:Japan; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D016272:Occupational Health / Q000706:statistics & numerical data*; D010809:Physical Fitness; D011056:Political Systems; D012737:Sex Factors; D013315:Stress, Psychological; D006113:United Kingdom; D016526:Workload / Q000523:psychology* / Q000706:statistics & numerical data