Social inequalities in the association between partner/marital status and health among workers in Spain.

The objectives of this study are to examine the association between partner/marital status and several health outcomes among workers and to assess whether it depends on gender and occupational social class. The sample was composed of all workers aged 21-64 years interviewed in the 2006 Spanish National Health Survey (8563 men and 5881 women). Partner/marital status had seven categories: married and living with the spouse (reference category), married and not living with the spouse, cohabiting, single and living with parents, single and not living with parents, separated/divorced and widowed. Four health outcomes were analysed: self-perceived health status, mental health, psychiatric drugs consumption and hypertension. Multiple logistic regression models stratified by sex and social class were fitted. Female manual workers who were cohabiting were more likely to report poor self-perceived health status, poor mental health status, psychiatric medication consumption and hypertension than their married and living with the spouse counterparts. In that group the prevalence of poor health outcomes was even higher when compared with single people. Among male non-manual workers, being married and not living with the spouse was associated with poor self-perceived health status, poor mental health status and hypertension. There were almost no differences in health between being married and the rest of partner/marital status categories for different combinations of gender and social class and, even, some groups of single people reported better health outcomes than people who were married. Our results show no evidence that being married and living with the spouse is unequivocally linked to better health status among Spanish workers. They emphasize the importance of not only considering marital status, but also partner status, as well as the role of gender, social class and the sociocultural context in the analysis of the association between family characteristics and health.

Gender and social class differences in the association between early retirement and health in Spain.

OBJECTIVES: We sought to examine the association between reasons for early retirement and health status and to assess whether this association differs by gender and social class. METHODS: The sample was all people currently working or retired between 50 and 64 years of age (2,497 men and 1,420 women) who were interviewed in the 2006 Spanish National Health Survey. The health outcomes analyzed were self-perceived health status and mental health. Multiple logistic regression models stratified by gender and occupational social class were fitted. RESULTS: Female manual workers who were forced into early retirement due to organizational reasons were more likely to report poor self-perceived health status (adjusted odds ration [aOR], 4.04; 95% confidence interval [CI], 1.44-11.32) and poor mental health (aOR, 2.70; 95% CI, 1.15-6.33), whereas no such association was observed among male workers or among female nonmanual workers. Early retirement on health grounds was associated with both health outcomes in all groups, but retirement because of age, voluntary retirement, and retirement for other reasons were not related to poor health outcomes in any group analyzed. DISCUSSION: Forced early retirement owing to organizational reasons is related to poor health indicators only among female manual workers. Results highlight the importance of paying more attention to the potential vulnerability of female manual workers in downsizing processes as well as in early retirement policies.

[Gender inequalities in the Spanish Public Health and Health Administration Society (2000-2009)]. / Desigualdades de género en la Sociedad Española de Salud Pública y Administración Sanitaria (2000-2009).

OBJECTIVE: To describe gender inequalities in positions of leadership and scientific recognition in activities carried out by the Spanish Public Health and Health Administration Society (SESPAS), the Spanish Epidemiology Society (SEE) and the Health Economics Association (AES) for 2000-2009. METHODS: We performed a descriptive study of the gender distribution of the boards of directors, scientific and conference organization committees and chairpersons of the SESPAS, SEE and AES. The gender distribution of the editorial board of Gaceta Sanitaria, and of the authors of editorials published in the journal, as well as that of the editors of SESPAS Reports, was also analyzed. RESULTS: Between 2000 and 2009, there was a slight increase in women's participation in the SESPAS and there was greater gender parity in the SEE. However, representation of women in the AES was low. CONCLUSIONS: The causes of gender inequalities in public health professional societies should continue to be analyzed and actions should be taken to change the present situation.

Occupational epidemiology and work related inequalities in health: a gender perspective for two complementary approaches to work and health research.

OBJECTIVES: To provide a framework for epidemiological research on work and health that combines classic occupational epidemiology and the consideration of work in a structural perspective focused on gender inequalities in health. METHODS: Gaps and limitations in classic occupational epidemiology, when considered from a gender perspective, are described. Limitations in research on work related gender inequalities in health are identified. Finally, some recommendations for future research are proposed. RESULTS: Classic occupational epidemiology has paid less attention to women's problems than men's. Research into work related gender inequalities in health has rarely considered either social class or the impact of family demands on men's health. In addition, it has rarely taken into account the potential interactions between gender, social class, employment status and family roles and the differences in social determinants of health according to the health indicator analysed. CONCLUSIONS: Occupational epidemiology should consider the role of sex and gender in examining exposures and associated health problems. Variables should be used that capture the specific work environments and health conditions of both sexes. The analysis of work and health from a gender perspective should take into account the complex interactions between gender, family roles, employment status and social class.