Health inequalities among young workers: the mediating role of working conditions and company characteristics.

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH International Archives of Occupational and Environmental Health Pub Date : 2023-12-01 Epub Date: 2023-10-09 DOI:10.1007/s00420-023-02010-6

Marvin Reuter, Claudia R Pischke, Mariann Rigo, Katharina Diehl, Jacob Spallek, Matthias Richter, Claudia Hövener, Nico Dragano

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Abstract

Objective: Few studies have investigated health inequalities among young workers. The objectives of this study are to assess the extent of health inequalities in a sample of job starters and to explore the contribution of job demands and organisational factors.

Methods: We analyze data from the BIBB/BAuA Youth Employment Survey 2012. The cross-sectional survey includes a representative sample of 3214 German employees, apprentices, and trainees aged 15-24 years. Individuals were grouped by their years of schooling into low (< 12 years) and high levels of education (≥ 12 years). Regression analysis estimated the link between education and four health outcomes: self-rated health, number of health events, musculoskeletal symptoms, and mental health problems over the last 12 months. Counterfactual mediation analysis tested for indirect effects of education via working conditions (i.e., physical and psychosocial job demands) and company characteristics (i.e., company size, health prevention measures, financial situation, downsizing). All analyses were adjusted for age, sex, nationality, region, working hours, job tenure, employment relationship, and economic sector.

Results: Highly educated workers reported better self-rated health (b = 0.24, 95% CI 0.18-0.31) and lower numbers of health events (Rate Ratio (RR) = 0.74, 95% CI 0.67-0.82), musculoskeletal symptoms (RR = 0.73, 95% CI 0.66-0.80) and mental health problems (RR = 0.84, 95% CI 0.76-0.93). Total job demands explained between 21.6% and 87.2% of the educational differences (depending on health outcome). Unfavourable company characteristics were associated with worse health, but showed no or only small mediation effects.

Conclusions: Health inequalities are already present at the early working career due to socio-economically stratified working hazards. To enhance prevention measures that aim at reducing inequalities in workplace health, we propose shifting attention towards earlier stages of life.

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年轻工人的健康不平等：工作条件和公司特征的中介作用。

目的：很少有研究调查年轻工人的健康不平等。本研究的目的是评估一个刚开始工作的样本中健康不平等的程度，并探索工作需求和组织因素的贡献。方法：我们分析了BIBB/BAuA 2012年青年就业调查的数据。横断面调查包括3214名15-24岁的德国雇员、学徒和受训人员的代表性样本。个体按受教育年限分为低（结果：受过高等教育的工人自我评价的健康状况较好（b = 0.24，95%CI 0.18-0.31）和较低的健康事件数（比率（RR） = 0.74，95%CI 0.67-0.82），肌肉骨骼症状（RR = 0.73，95%CI 0.66-0.80）和心理健康问题（RR = 0.84，95%CI 0.76-0.93）。总的工作需求解释了21.6%-87.2%的教育差异（取决于健康结果）。不利的公司特征与较差的健康状况有关，但没有或只有很小的中介作用。结论：由于社会经济分层的工作危害，在职业生涯早期就已经存在健康不平等现象。为了加强旨在减少工作场所健康不平等的预防措施，我们建议将注意力转移到生命的早期阶段。

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来源期刊

International Archives of Occupational and Environmental Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

6.70%

发文量

127

审稿时长

3 months

期刊介绍： International Archives of Occupational and Environmental Health publishes Editorials, Review Articles, Original Articles, and Letters to the Editor. It welcomes any manuscripts dealing with occupational or ambient environmental problems, with a special interest in research at the interface of occupational health and clinical medicine. The scope ranges from Biological Monitoring to Dermatology, from Fibers and Dust to Human Toxicology, from Nanomaterials and Ultra-fine Dust to Night- and Shift Work, from Psycho-mental Distress and Burnout to Vibrations. A complete list of topics can be found on the right-hand side under For authors and editors. In addition, all papers should be based on present-day standards and relate to: -Clinical and epidemiological studies on morbidity and mortality -Clinical epidemiological studies on the parameters relevant to the estimation of health risks -Human experimental studies on environmental health effects. Animal experiments are only acceptable if relevant to pathogenic aspects. -Methods for studying the topics mentioned above.