A compassionate university for serious illness, death, and bereavement: Qualitative study of student and staff experiences and support needs.

Serious illness, death, and bereavement are common experiences within the work and study context. This study aims to explore the experiences and support needs of university students and staff confronted with serious illness, death, and bereavement. Semi-structured interviews and focus groups were conducted with 21 students and 26 staff. A thematic analysis resulted in three overarching themes: the university as a high-pressure environment; navigating the complex university information and support system; and disenfranchized grief. Four themes were identified in terms of what participants needed from the university: clear processes and procedures; flexibility in policy application; proactive support and recognition; and activities to enhance awareness and interpersonal communication skills. Findings from this study could enable higher education institutions to become more compassionate schools and workplaces.

Underemployment, overemployment and deterioration of mental health: the role of job rewards.

OBJECTIVES: Working more (overemployment) or less (underemployment) than preferred has been associated with poor mental health in cross-sectional studies, but longitudinal evidence is scarce. We investigate whether under- and overemployment is associated with 2-year changes of mental health and whether associations vary by job rewards (i.e. high earnings, job security, promotion prospects and occupational prestige). METHODS: We used two waves of the German Socio-Economic Panel (GSOEP), with information on mental health collected in 2006 and 2008. Workers in paid employment (3266 men and 3139 women) who did not change jobs between 2006 and 2008, aged 20-60 years were selected. Under- and overemployment was assessed using the discrepancy between the actual and preferred working hours. Mental health was assessed using the Mental Component Summary (MCS) score, a subscale from the Short Form 12 Health Survey. Questions on rewards at work were added and divided into tertiles. Conditional change models were estimated to predict change in MCS. RESULTS: Findings indicate that overemployment and low reward at work (for men and women) were linked to a reduction in mental health. Underemployment was not related to a reduction in mental health. Albeit associations between under-/overemployment and mental health slightly differed across levels of reward, interactions did not reach statistical significance. CONCLUSIONS: Our findings demonstrate that overemployment was related to negative mental health change, and that this relationship held true both for people with high and with low reward at work.

New perspectives on occupational health and safety in immigrant populations: studying the intersection between immigrant background and gender.

OBJECTIVES: Few studies investigating health inequalities pay attention to the intersection between several social determinants of health. The purpose of this article is to examine the relation between perceptions of work-related health and safety risk (WHSR) and (1) immigrant background and (2) gender in the EU-15. The effects are controlled for educational attainment, the quality of work (QOW) and occupation. DESIGN: Pooled data from the European Social Survey 2004 and 2010 are used in this study. The sample is restricted to respondents of working age (16-65 years) (N = 17,468). The immigrants are divided into two groups according to their country of origin: (semi-)periphery and core countries. Both groups of immigrants are compared to natives. Additionally, the research population is stratified by gender. Descriptive statistics and logistic regression analyses are used. RESULTS: Core immigrants (both men and women) do not differ from natives in terms of QOW. (Semi-)periphery immigrants (both men and women) are employed in jobs with lower QOW. While no differences in WHSR are found among men, female immigrants (both (semi-)periphery and core) have significantly more WHSR compared to native women. Although WHSR is generally lower in women, (semi-)periphery women have a similar prevalence of WHSR as men. CONCLUSION: (Semi-)periphery immigrants are employed in lower quality jobs, while core immigrants do not differ from natives in that regard. Female immigrant workers--especially those from (semi-)periphery countries--have higher WHSR compared to native women. Our findings highlight the importance of an intersectional approach in the study of work-related health inequalities.

Contemporary employment arrangements and mental well-being in men and women across Europe: a cross-sectional study.

INTRODUCTION: There is the tendency in occupational health research of approximating the 'changed world of work' with a sole focus on the intrinsic characteristics of the work task, encompassing the job content and working conditions. This is insufficient to explain the mental health risks associated with contemporary paid work as not only the nature of work tasks have changed but also the terms and conditions of employment. The main aim of the present study is to investigate whether a set of indicators referring to quality of the employment arrangement is associated with the well-being of people in salaried employment. Associations between the quality of contemporary employment arrangements and mental well-being in salaried workers are investigated through a multidimensional set of indicators for employment quality (contract type; income; irregular and/or unsocial working hours; employment status; training; participation; and representation). The second and third aim are to investigate whether the relation between employment quality and mental well-being is different for employed men and women and across different welfare regimes. METHODS: Cross-sectional data of salaried workers aged 15-65 from 21 EU-member states (n =11,940) were obtained from the 2010 European Social Survey. Linear regression analyses were performed. RESULTS: For both men and women, and irrespective of welfare regime, several sub-dimensions of low employment quality are significantly related with poor mental well-being. Most of the significant relations persist after controlling for intrinsic job characteristics. An insufficient household income and irregular and/or unsocial working hours are the strongest predictors of poor mental well-being. A differential vulnerability of employed men and women to the sub-dimensions of employment quality is found in Traditional family and Southern European welfare regimes. CONCLUSIONS: There are significant relations between indicators of low employment quality and poor mental well-being, also when intrinsic characteristics of the work task are controlled. Gender differences are least pronounced in Earner-carer countries.

Structural and intermediary determinants of social inequalities in the mental well-being of European workers: a relational approach.

BACKGROUND: The objective of this study is to examine social inequalities in employee mental well-being, using relational social class indicators. Relational social class indicators are based on theoretical insights about the mechanisms generating social (health) inequalities. Additionally, it is examined whether the psychosocial work environment and employment quality act as intermediary determinants of social class inequalities in mental well-being, simultaneously testing the mediation (differential exposure) and moderation (differential vulnerability) hypotheses. METHODS: Data from the European Social Survey Round 2 (2004/5) and Round 5 (2010) were analysed. Mental well-being was assessed by the WHO Well-being Index. The measure for social class was inspired by E.O. Wright's class scheme. Three-level linear multilevel modelling was used to account for clustering of employees within research years and countries. RESULTS: We found social class inequalities in mental well-being in the European working population for both men and women. Compared to unskilled workers, managers reported the best mental well-being, while supervisors held an intermediary position. As regards the mediation hypothesis, an unfavourable psychosocial work environment and low-quality employment conditions mediated the relation between social class and poor mental well-being in both men and women. However, low quality of employment relations only mediated the "social class-mental well-being" association in the male sample. As regards the moderation hypothesis, modification effects were seen for the psychosocial work environment and employment conditions in both men and women. CONCLUSION: Relational indicators of social class are related to mental well-being in European employees. Relational accounts of social class are complementary to stratification indicators in social epidemiology. From a policy perspective, better employee mental well-being and less social class inequality could be achieved through initiatives addressing the unequal social relations generated by structural positions in the labour process.

Is it the Past or the Present? Employment Quality, Unemployment History, Psychological Distress and Mental Wellbeing in the United Kingdom.

Low employment quality and precarious employment have been associated with adverse mental health outcomes, yet the extent to which this association may be explained by the experience of unemployment "scarring" has not yet been explored. From a life course perspective, understanding this possible confounding is necessary. Drawing on the United Kingdom's Understanding Society dataset and using latent class analysis, we derived a typology of employment quality across six dimensions and assessed the links between individuals' employment quality, unemployment history, and mental well-being and psychological distress. Our results show that precarious types of employment as well as a higher quality "protected part-time" were linked to low mental well-being, though important gender differences were noted. Accounting for past unemployment did not fully explain these associations. No such adverse associations were observed for increased psychological distress. Our results help further the understanding of employment quality as a social determinant of health and highlight the need for both life course and gender-sensitive research in this area.

Psychological capital and social class: A capital approach to understanding positive psychological states and their role in explaining social inequalities.

Psychological capital (PsyCap) is a multidimensional concept entailing hope, self-efficacy, optimism, and resilience. This paper argues that it can be considered a form of "capital" explaining social inequality. We test whether PsyCap can be integrated into the Bourdieusian capital framework by assessing its relationship with social, economic, and cultural capital. We also identify different types of social positions based on the volume and composition of psychological, economic, cultural, and social capital. We use cross-sectional data from the European Social Survey of 2012 (N = 35,313 respondents; 29 countries). To test the associations with the Bourdieusian capital types, we calculated multilevel spearman rank correlations and performed confirmatory factor analyses (CFA). Latent Class Analysis identified different types of social positions. We found positive weak correlations between PsyCap and the indicators of cultural capital (r ≤ .14) and positive moderate correlations with the indicators of economic and social capital (r ≤ .24). The results of the CFA showed that the fit of the 4-capital model was superior to that of the 3-capital model. We identified six types of social positions: two deprived types (with overall low capital levels); two well-off types (with overall high capital levels) and two types with high psychological and social capital in combination with varying levels of cultural and economic capital. Including PsyCap in the Bourdieusian capital framework acknowledges the power of positive psychological states regarding processes of social mobility and social inequality on the one hand and calls for understanding PsyCap as a social and group-level phenomenon on the other hand. As such, integrating PsyCap into the Bourdieusian framework can help to address the longstanding issue of understanding the relationship between social and individual differences in the study of social inequalities.

Developing and evaluating Compassionate Workplace Programs to promote health and wellbeing around serious illness, dying and loss in the workplace (EU-CoWork): a transdisciplinary, cross-national research project.

Background: Most employees will experience serious illness, caregiving, dying and loss (End-of-Life (EoL) experiences) at multiple points throughout their working lives. These experiences impact affected employees but also their colleagues in terms of health and wellbeing, and the workplace as a whole in terms of workplace safety, productivity and labour relations. The impact of EoL experiences on employees means that workplaces are called to play a more active role in providing support for EoL experiences. Aim: To describe how the EU-CoWork (2024-2028) project addresses its main aims to (1) create Compassionate Workplace cultures, practices and policies and improve health and wellbeing for employees dealing with EoL experiences in different national work contexts in Europe; (2) describe and evaluate the process of co-creation and implementation of Compassionate Workplace Programs (CWPs) and how these influence the programs' outcomes. Design: EU-CoWork employs a facilitated and co-creative Developmental Evaluation approach to the development of 12 tailored CWPs across four European countries (Belgium, Austria, Sweden and Greece). Methods: To evaluate the outcomes and processes leading to these outcomes, a mixed-methods Realist Evaluation methodology is applied, formulating and testing Context-Mechanism-Outcomes configurations and combining longitudinal quantitative and qualitative data collections. Results: EU-CoWork will generate evidence to support an expanded model of occupational health and safety risk factors sensitive to the specific challenges related to employees' EoL experiences. In doing so, several challenges will have to be navigated: involving employees with EoL experiences while avoiding overburdening them, avoiding tokenistic engagement, managing power differentials, balancing the need for scientific rigour with the flexibility required in co-creation, reconciling different epistemologies and disciplinary traditions and organisational resistance to change. Conclusion: There are potential long-lasting broader societal impacts through the stimulation of open discourse on EoL topics, the reconciliation of work and care, and changes in gendered work and care patterns.

Values, Health and Well-Being of Young Europeans Not in Employment, Education or Training (NEET).

Youth unemployment is a problem that undermines young people's health and well-being and is also a concern for their immediate communities and society. Human values predict health-related behaviour; however, this relation is very little studied and not examined earlier among NEET (not in employment, education or training) young people. This study aimed to explore the association between four higher-order human values (conservation, openness to change, self-enhancement, self-transcendence), self-rated health (SRH) and subjective well-being (SW) among NEET young men and women (n = 3842) across European regions. Pooled European Social Survey data from 2010-2018 were used. First, we run linear regression analysis stratified by European socio-cultural regions and gender. Then, multilevel analyses by gender with interactions were performed. The results show expected variation in value profiles across genders and regions and corresponding differences in SRH and SW. Significant associations between values and SRH and SW were found among both genders and across the regions; however, the results did not entirely confirm the expectations about the "healthiness" of specific values. More likely, prevailing values in societies, such as the social norm to work, might shape these associations. This study contributes to a deeper understanding of the factors affecting NEETs' health and well-being.

Does employment status matter for job quality? A cross-national perspective.

BACKGROUND: Dual labour market theory raises questions about the relationship between non-standard employment and job quality. While scattered empirical evidence exists, there is a paucity of systematic evidence on the relationship between workers' employment status and job quality. OBJECTIVE: The authors investigated the relation between workers' employment status (e.g., open-ended, long- and short-term fixed contracts, economically dependent and independent solo self-employment, and self-employment with employees) and important dimensions of job quality (JQ) (e.g., employment prospects, physical work environment, skills and discretion, and working times quality). Cross-national variation in that relation and causes of that variation (e.g., country-level unemployment rate and labour market efficiency) were also investigated. METHODS: Hierarchical regression modelling was applied using a sample of 34,094 workers from the European Working Conditions Survey 2015. RESULTS: The study highlighted a negative association between fixed-term contracts and JQ. For self-employed workers (except economically dependent self-employed workers) a generally positive association was observed. In this study, also positive associations were found between labour market efficiency at the country-level and some JQ indicators. National unemployment rates were negatively associated to most JQ indicators. CONCLUSION: Non-standard employment contracts exhibited poorer job quality than open-ended contracts. Stronger labour market organization centred around indicators of both flexibility and equity related to more beneficial job quality for all employment statuses, thereby promoting more labour market inclusivity.

Researching Compassionate Communities From an Interdisciplinary Perspective: The Case of the Compassionate Communities Center of Expertise.

Compassionate Communities are places and environments in which people, networks, and institutions actively work together and are empowered to improve the circumstances, health, and well-being of those facing serious illness, death, dying, and loss. The study of their development, implementation, and evaluation requires an interdisciplinary research approach that has hitherto been lacking. In 2020, 8 research groups from 4 faculties at Vrije Universiteit Brussel united in the interdisciplinary Compassionate Communities Center of Expertise (COCO) to investigate Compassionate Communities. This article describes the first results of COCO: (a) an interdisciplinary mode of collaboration, (b) a shared conceptual understanding and definition of Compassionate Communities, and (c) a shared research agenda on Compassionate Communities.

Linked work lives: The interrelation of own and partner's employment history and their relationship with mental health in older European couples.

INTRODUCTION: There is strong evidence for the importance of previous employment for mental health at older age but little is known about the role of partner's employment history in this. Life course theory suggests that individual trajectories are linked and evidence from cross-sectional studies suggest that there are cross-over effects within couples. Therefore, the present study tests the interdependence of own and partner's employment history and their relationship with depressive symptoms. METHODS: Analyses are based on retrospective data from the SHARE survey for 5664 long-term couples aged 50 or older, with employment information for each age between 30 and 50 (full-time, part-time, domestic work or non-employed). We use sequence analysis to group similar employment histories and relate own and partner's employment histories with depressive symptoms (EURO-D) using regression models. RESULTS: Results show that own and partner's employment history are interdependent and mainly follow traditional divisions of paid work, with the majority of men working full-time and women often working part-time or not working. We find increased depressive symptoms after longer episodes of non-employment for men but not for women, regardless of partner's employment situation. CONCLUSION: The study shows that mental health later in life is related to own employment history and that this relationship is not moderated by partner's employment history. The results need to be interpreted against cultural and gender role norms at the time.

Employment status and mortality in the context of high and low regional unemployment levels in Belgium (2001-2011): A test of the social norm hypothesis across educational levels.

Because of compositional effects (more highly educated unemployed) and differences in the vulnerability towards the health consequences of unemployment (i.e. disappointment paradox hypothesis and/or status inconsistency for highly educated unemployed), it is argued that indicators of educational attainment need to be included when investigating the social norm of unemployment. Data from the 2001 census linked to register data from 2001-2011 are used, selecting all Belgian employed and unemployed between 30 and 59-year-old at time of the census. Poisson multilevel modelling was used to account for clustering of respondents within sub-districts. For individuals with low education levels, the relative difference in mortality rate ratios between the unemployed and employed is smallest in those regions where aggregate unemployment levels are high. For highly educated, this social norm effect was not found. This study suggest that the social norm effect is stronger for workers with low education levels, while highly educated workers suffer from disappointment and status inconsistency.

Working Hours Mismatch, Macroeconomic Changes, and Mental Well-being in Europe.

This study explores the association between involuntarily working less or more than the standard workweek and poor mental well-being, and whether this relationship is dependent upon (changing) national-level unemployment and gross domestic product growth rates. Data from the European Social Survey Round 2 (2004-2005) and Round 5 (2010) were analyzed. The sample included 16,224 male and 16,184 female employees. Mental well-being was assessed by the World Health Organization Well-being Index. Three-level linear multilevel modeling was used to account for clustering of employees within research years and countries. Working involuntary long hours was positively associated with poor mental well-being for men. For women, working voluntary long, involuntary long, and involuntary short hours were positively associated with poor mental well-being. The mental well-being of women working voluntary and involuntary long hours was negatively influenced by deteriorating economic conditions. This study suggests women are more vulnerable to the effects of long working hours and working hours mismatch on mental well-being, especially during difficult economic periods.

Employment and Labor Market Results of the SOPHIE Project: Concepts, Analyses, and Policies.

This article reports evidence gained by the SOPHIE Project regarding employment and labor market-related policies. In the first step, quality of employment and of precarious and informal employment in Europe were conceptualized and defined. Based on these definitions, we analyzed changes in the prevalence and population distribution of key health-affecting characteristics of employment and work between times of economic prosperity and economic crisis in Europe and investigated their impact on health outcomes. Additionally, we examined the effects of several employment and labor market-related policies on factors affecting health equity, including a specific analysis concerning work-related gender equity policies and case studies in different European countries. Our findings show that there is a need to standardize definitions and indicators of (the quality of) employment conditions and improve information systems. This is challenging given the important differences between and within European countries. In our results, low quality of employment and precarious employment is associated with poor mental health. In order to protect the well-being of workers and reduce work-related health inequalities, policies leading to precarious working and employment conditions need to be suspended. Instead, efforts should be made to improve the security and quality of employment for all workers.

Gender Policies and Gender Inequalities in Health in Europe: Results of the SOPHIE Project.

The aim of this article is to explain the results of the SOPHIE project regarding the effect of gender policies on gender inequalities in health in Europe. We start with the results of a systematic review on how gender regimes and gender equality policies at the country level impact women's health and gender inequalities in health. Then, we report on three empirical analyses on the relationship between different family policy models existing in Europe and gender inequalities in health. Finally we present four case studies on specific examples of gender policies or determinants of gender inequalities in health. The results show that policies that support women's participation in the labor force and decrease their burden of care, such as public services and support for families and entitlements for fathers, are related to lower levels of gender inequality in terms of health. In addition, public services and benefits for disabled and dependent people can reduce the burden placed on family caregivers and hence improve their health. In the context of the current economic crisis, gender equality policies should be maintained or improved.

Do flexicurity policies protect workers from the adverse health consequences of temporary employment? A cross-national comparative analysis.

Flexicurity policies comprise a relatively novel approach to the regulation of work and welfare that aims to combine labour market flexibility with social security. Advocates of this approach argue that, by striking the right balance between flexibility and security, flexicurity policies allow firms to take advantage of loose contractual arrangements in an increasingly competitive economic environment while simultaneously protecting workers from the adverse health and social consequences of flexible forms of employment. In this study, we use multilevel Poisson regression models to test the theoretical claim of the flexicurity approach using data for 23 countries across three waves of the European Social Survey. We construct an institutional typology of labour market regulation and social security to evaluate whether inequalities in self-reported health and limiting longstanding illness between temporary workers and their permanent counterparts are smaller in countries that most closely approximate the ideal type described by advocates of the flexicurity approach. Our results indicate that, while the association between temporary employment and health varies across countries, institutional configurations of labour market regulation and social security do not provide a meaningful explanation for this cross-national variation. Contrary to the expectations of the flexicurity hypothesis, our data do not indicate that employment-related inequalities are smaller in countries that approximate the flexicurity approach. We discuss potential explanations for these findings and conclude that there remains a relative lack of evidence in support of the theoretical claims of the flexicurity approach.

Neo-Marxian social class inequalities in the mental well-being of employed men and women: the role of European welfare regimes.

The relation between "neo-Marxian" social class (NMSC) and health in the working population has received considerable attention in public health research. However, less is known about the distribution of mental well-being according to NMSC in a European context. The objectives of this study are (i) to analyse the association of mental well-being and NMSC among employees in Europe (using a welfare regime typology), (ii) to investigate whether the relation between NMSC and mental well-being is the same in women compared to men within each welfare regime, and (iii) to examine within each welfare regime the role of the gender division of labour and job quality as potential mediating factors in explaining this association. Data from the European Social Survey Round 5 (2010) were analysed. Mental well-being was assessed by the WHO Well-being Index. Social class was measured through E.O. Wright's social class scheme. Models separated by sex were generated using Poisson regression with a robust error variance. The associations were presented as prevalence ratios with 95% confidence intervals. Women reported NMSC differences in mental well-being in State corporatist/family support and Southern welfare regimes. Men reported NMSC differences in mental well-being in all but the Basic security/market-oriented welfare regimes. Gender inequalities were more marked and widespread in Basic security/market-oriented welfare regimes. In all welfare regimes job quality (partly) explained NMSC inequalities in mental well-being for men, the role of the gender division of labour was unclear. This study showed that the relationship between NMSC and mental well-being among employees differs by gender and welfare regimes. It confirms the importance of NMSC and welfare regimes to explain gender and social class inequalities in mental well-being.

The influence of gender equality policies on gender inequalities in health in Europe.

Few studies have addressed the effect of gender policies on women's health and gender inequalities in health. This study aims to analyse the relationship between the orientation of public gender equality policies and gender inequalities in health in European countries, and whether this relationship is mediated by gender equality at country level or by other individual social determinants of health. A multilevel cross-sectional study was performed using individual-level data extracted from the European Social Survey 2010. The study sample consisted of 23,782 men and 28,655 women from 26 European countries. The dependent variable was self-perceived health. Individual independent variables were gender, age, immigrant status, educational level, partner status and employment status. The main contextual independent variable was a modification of Korpi's typology of family policy models (Dual-earner, Traditional-Central, Traditional-Southern, Market-oriented and Contradictory). Other contextual variables were the Gender Empowerment Measure (GEM), to measure country-level gender equality, and the Gross Domestic Product (GDP). For each country and country typology the prevalence of fair/poor health by gender was calculated and prevalence ratios (PR, women compared to men) and 95% confidence intervals (CI) were computed. Multilevel robust Poisson regression models were fitted. Women had poorer self-perceived health than men in countries with traditional family policies (PR = 1.13, 95%CI: 1.07-1.21 in Traditional-Central and PR = 1.27, 95%CI: 1.19-1.35 in Traditional-Southern) and in Contradictory countries (PR = 1.08, 95%CI: 1.05-1.11). In multilevel models, only gender inequalities in Traditional-Southern countries were significantly higher than those in Dual-earner countries. Gender inequalities in self-perceived health were higher, women reporting worse self-perceived health than men, in countries with family policies that were less oriented to gender equality (especially in the Traditional-Southern country-group). This was partially explained by gender inequalities in the individual social determinants of health but not by GEM or GDP.