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| 2. |
- Elwér, Sofia, 1979-
(författare)
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Gender equality and health experiences : workplace patterns in Northern Sweden
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Gendered practices of working life create gender inequalities through horizontal and vertical gender segregation in work, which may lead to gender inequalities in health experiences. The workplace is an important part of the social circumstances under which health opportunities and constraints are shaped. The workplace has also been identified as an important arena for gender constructions. Still, there is a lack of research about the relations between workplace gender equality and health experiences. The aim of this thesis was to explore gender equality and health experiences in a workplace setting.Qualitative and quantitative methods were used. In the qualitative studies all caregiving staff at two establishments providing care for elderly was invited to participate in focus groups (Papers I & II). A moderator led 14 focusgroup discussions. Qualitative content analysis was used to analyse the transcribed discussions. For the quantitative studies questionnaire data from the Northern Swedish Cohort (n=836) were analysed and supplemented with register data about the participants’ workplaces. The register data were used to stratify the workplaces according to gender composition (paper IV) and to create gender equality indicators of the number of women and men at the workplace, education, salary and parental leave (Paper III). Cluster analysis was used to identify patterns of gender equality at the workplaces. Logistic regression analysis, adjusting for individual socio-demographics and previous psychological distress, were used to analyse psychological distress in relation to both clusters and gender compositions.This thesis identifies various workplace patterns of gender equality and how they are related to health experiences. The results from the focus group study showed that workplace stressors had a structural character, often originating from societal processes outside the own organization, whereas health resources had a relational character and were constructed within the organization (paper I). Gender equality was seen as a structural issue not connected to the individual health experiences and gender inequalities were justified through focusing on personalities and interests in work division (paper II). The cluster analysis resulted in six distinctive clusters with different workplace patterns of gender equality (paper III). The most gender-equal cluster was characterized by gender equality in salary and parental leave and was associated with the lowest prevalence of psychological distress, with no significant differences between women and men. The clusters were associated with psychological distress among women only. The highest odds for psychological distress among women were found in a traditional unequal cluster. Analyses of the gender composition at the workplace showed that the highest prevalence of psychological distress was found at workplaces with a mixed gender composition (paper IV). The psychosocial work environment was rather similar independent of the workplace gender composition.The factors most strongly associated with psychological distress were high demands and low control at workplaces with more men, being looked down upon at workplaces with a mixed gender composition, and social support at workplaces with more women.Gender perspectives highlight the importance of gender relations in research on work-related health. Gender inequalities at workplaces can be part of the explanation to women’s worse self-rated health. A multidimensional view of gender equality is necessary to understand health consequences of specific workplace situations. Workplaces are important arenas for health promotion activities and gender equality aspects needs to be taken into account to reach both women and men. Adequate health promotion needs to shift focus from individual health strategies to structural solutions that can challenge the root of the problem.
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- Elwer, Sofia, et al.
(författare)
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Gender (in)equality among employees in elder care : implications for health
- 2012
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Ingår i: International Journal for Equity in Health. - : BioMed Central. - 1475-9276. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Gendered practices of working life create gender inequalities through horizontal and vertical gender segregation in work, which may lead to inequalities in health between women and men. Gender equality could therefore be a key element of health equity in working life. Our aim was to analyze what gender (in) equality means for the employees at a woman-dominated workplace and discuss possible implications for health experiences.Methods: All caregiving staff at two workplaces in elder care within a municipality in the north of Sweden were invited to participate in the study. Forty-five employees participated, 38 women and 7 men. Seven focus group discussions were performed and led by a moderator. Qualitative content analysis was used to analyze the focus groups.Results: We identified two themes. "Advocating gender equality in principle" showed how gender (in) equality was seen as a structural issue not connected to the individual health experiences. "Justifying inequality with individualism" showed how the caregivers focused on personalities and interests as a justification of gender inequalities in work division. The justification of gender inequality resulted in a gendered work division which may be related to health inequalities between women and men. Gender inequalities in work division were primarily understood in terms of personality and interests and not in terms of gender.Conclusion: The health experience of the participants was affected by gender (in) equality in terms of a gendered work division. However, the participants did not see the gendered work division as a gender equality issue. Gender perspectives are needed to improve the health of the employees at the workplaces through shifting from individual to structural solutions. A healthy-setting approach considering gender relations is needed to achieve gender equality and fairness in health status between women and men.
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| 4. |
- Elwér, Sofia, et al.
(författare)
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Health against the odds : experiences of employees in elder care from a gender perspective
- 2010
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Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 20:9, s. 1202-1212
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Tidskriftsartikel (refereegranskat)abstract
- Women-dominated elder care in Sweden is a low-paid, low-status job with a high prevalence of sick leave. Our aim was to analyze health experiences of employees in elder care from a gender perspective. All caregiving staff at two establishments providing care to the elderly were invited to participate in the study. A moderator led seven focus group discussions. Qualitative content analysis was used to analyze the transcribed focus groups. We identified two central themes in relation to the employees' health. "Working against the odds" describes gendered workplace stressors of a structural character, to a large extent triggered by societal processes outside the organization. "Making work matter" refers to gendered health resources with a relational character, constructed within the organization. Health-promoting programs directed toward women-dominated workplaces need to include a gender perspective, and focus on creating structural, supportive environments to avoid the negative health effects of the stressors.
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| 5. |
- Elwér, Sofia, et al.
(författare)
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Life course models of economic stress and poor mental health in mid-adulthood : Results from the prospective Northern Swedish Cohort
- 2015
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 43:8, s. 833-840
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim was to analyse the association between economic stress during youth and adulthood, and poor mental health through life course models of (1) accumulation of risk and (2) sensitive period. Methods: The study was based on the Northern Sweden Cohort, a 26-year prospective cohort (N = 1010 in 2007; 94% of those participating in 1981 still alive) ranging from adolescence to middle age. Economic stress was measured at age 16, 21, 30 and 42 years. Two life course models of accumulation of risk and sensitive period were analysed using ordinal regression with internalized symptoms of mental health as outcome. Results: Exposure of economic stress at several life course periods was associated with higher odds of internalized mental health symptoms for both women and men, which supports the accumulated risk model. No support for a sensitive period was found for the whole sample. For men, however, adolescence appears to be a sensitive period during which the exposure to economic stress has negative mental health consequences later in life independently of economic stress at other ages. Conclusion: This study confirms that the duration of economic stress between adolescence and middle age is important for mental health. In addition, the results give some indication of a sensitive period of exposure to economic stress during adolescence for men, although more research is needed to confirm possible gender differences.
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| 6. |
- Elwér, Sofia, 1979-, et al.
(författare)
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Patterns of gender equality at workplaces and psychological distress
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Research in the field of occupational health often uses a risk factor approach which has been criticized by feminist researchers for not considering the combination of many different variables that are at play simultaneously. To overcome this shortcoming this study aims to identify patterns of gender equality at workplaces and to investigate how these patterns are associated with psychological distress. Questionnaire data from the Northern Swedish Cohort (n=715) have been analysed and supplemented with register data about the participants’ workplaces. The register data were used to create gender equality indicators of women/men ratios of number of employees, educational level, salary and parental leave. Cluster analysis was used to identify patterns of gender equality at the workplaces. Differences in psychological distress between the clusters were analysed by chi-square test and logistic regression analyses, adjusting for individual socio-demographics and previous psychological distress. The cluster analysis resulted in six distinctive clusters with different patterns of gender equality at the workplaces that were associated to psychological distress for women but not for men. For women the highest odds of psychological distress was found on traditionally gender unequal workplaces. The lowest overall occurrence of psychological distress as well as same occurrence for women and men was found on the most gender equal workplaces. The results from this study support the convergence hypothesis as gender equality at the workplace does not only relate to better mental health for women, but also more similar occurrence of mental ill-health between women and men. This study highlights the importance of utilizing a multidimensional view of gender equality to understand its association to health outcomes. Health policies need to consider gender equality at the workplace level as a social determinant of health that is of importance for reducing differences in health outcomes for women and men.
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| 7. |
- Elwér, Sofia, 1979-, et al.
(författare)
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Workplace gender composition and psychological distress : the importance of the psychosocial work environment
- 2014
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Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 14, s. 241-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Health consequences of the gender segregated labour market have previously been demonstrated in the light of gender composition of occupations and workplaces, with somewhat mixed results. Associations between the gender composition and health status have been suggested to be shaped by the psychosocial work environment. The present study aims to analyse how workplace gender composition is related to psychological distress and to explore the importance of the psychosocial work environment for psychological distress at workplaces with different gender compositions.Methods: The study population consisted of participants from the Northern Swedish Cohort with a registered workplace in 2007 when the participants were 42 years old (N = 795). Questionnaire data were supplemented with register data on the gender composition of the participants' workplaces divided into three groups: workplaces with more women, mixed workplaces, and workplaces with more men. Associations between psychological distress and gender composition were analysed with multivariate logistic regression analysis adjusting for socioeconomic position, previous psychological distress, psychosocial work environment factors and gender. Logistic regression analyses (including interaction terms for gender composition and each work environment factor) were also used to assess differential associations between psychosocial work factor and psychological distress according to gender composition.Results: Working at workplaces with a mixed gender composition was related to a higher likelihood of psychological distress compared to workplaces with more men, after adjustments for socioeconomic position, psychological distress at age 21, psychosocial work environment factors and gender. Psychosocial work environment factors did not explain the association between gender composition and psychological distress.Conclusions: The association between gender composition and psychological distress cannot be explained by differences in the perception of the psychosocial work environment and thus the work environment hypothesis is not supported. Workplaces with a mixed gender composition needs further research attention to explain the negative development of psychological distress during working life for both women and men at these workplaces.
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| 8. |
- Hammarström, Anne, et al.
(författare)
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Central gender theoretical concepts in health research : the state of the art
- 2014
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ Publishing Group Ltd. - 0143-005X .- 1470-2738. ; 68:2, s. 185-190
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Tidskriftsartikel (refereegranskat)abstract
- Despite increasing awareness of the importance of gender perspectives in health science, there is conceptual confusion regarding the meaning and the use of central gender theoretical concepts. We argue that it is essential to clarify how central concepts are used within gender theory and how to apply them to health research. We identify six gender theoretical concepts as central and interlinked-but problematic and ambiguous in health science: sex, gender, intersectionality, embodiment, gender equity and gender equality. Our recommendations are that: the concepts sex and gender can benefit from a gender relational theoretical approach (ie, a focus on social processes and structures) but with additional attention to the interrelations between sex and gender; intersectionality should go beyond additive analyses to study complex intersections between the major factors which potentially influence health and ensure that gendered power relations and social context are included; we need to be aware of the various meanings given to embodiment, which achieve an integration of gender and health and attend to different levels of analyses to varying degrees; and appreciate that gender equality concerns absence of discrimination between women and men while gender equity focuses on women's and men's health needs, whether similar or different. We conclude that there is a constant need to justify and clarify our use of these concepts in order to advance gender theoretical development. Our analysis is an invitation for dialogue but also a call to make more effective use of the knowledge base which has already developed among gender theorists in health sciences in the manner proposed in this paper.
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| 9. |
- Harryson, Lisa, et al.
(författare)
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Mer jämställt mindre sjukskriving? En epidemiologisk studie om jämställdhet och sjukskrivning på arbetsplatser.
- 2017
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Ingår i: Tidskrift för Genusvetenskap. - Karlstad : Centrum för genusforskning, Karlstads universitet. - 1654-5443 .- 2001-1377. ; 38:1-2, s. 99-120
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Tidskriftsartikel (refereegranskat)abstract
- This study analyses how sick leave among women and men are related to patterns of gender equality at the workplace. The study is based on register data from the Longitudinal integration database for health insurance and labor studies (LISA), and includes 520 workplaces for 134 450 people. Indicators of gender equality at the workplace consist of women to men ratio in terms of number of employees, salaries, education and parental leave. Cluster analysis is used to identify patterns of gender equality. Differences in women’s and men’s sick leave are analysed by chi-square test and logistic regression analyses.The analysis compares sick leave between six clusters of workplaces with different patterns of gender equality: 1) unequal with higher scores for men, 2) majority of women and equal salary, 3) equal salary and more parental leave for men, 4) unequal with equal representation, 5) equal in divergent spheres, 6) traditionally unequal. None of the clusters were completely gender equal, but the result of the analysis shows that the most gender equal workplaces have the lowest level of sick leave. For both women and men, the odds for sick leave are higher in workplaces with a majority of women that otherwise are relatively gender equal. For men, the odds for sick leave were higher at traditionally gender unequal workplaces.An equal representation of women and men at the workplace does not necessarily imply gender equality in other aspects such as salary, education and parental leave. More gender equal workplaces yet have lower risk of sick leave for both women and men, even though women consistently have higher rates of sick leave. A multidimensional approach to gender inequality at the workplace is important for understanding the skewed distribution of sickness absence between women and men in the general population.
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| 10. |
- Harryson, Lisa, et al.
(författare)
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Örat mot marken, blicken mot horisonten : Västerbottensmodell för samordning avregionalt och lokalt folkhälsoarbete
- 2021
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Uppdrag: I denna rapport sammanfattas det regeringsuppdrag som Länsstyrelsen Västerbotten haft under åren 2019–2021. Syftet med uppdraget var att utveckla metoder och arbetssätt för samordning av ett regionalt arbete för en god och jämlik hälsa utifrån bestämningsfaktorerna i de åtta målområdena, med målet att skapa bättre förutsättningar för det lokala främjande och förebyggande folkhälsoarbetet i länet. Genomförande: Uppdraget har genomförts i nära samarbete mellan Länsstyrelsen Västerbotten, Region Västerbotten och Umeå Universitet. Tillsammans har dessa tre aktörer genomfört en omfattande och noggrann inventering av förutsättningarna för lokalt och regionalt folkhälsoarbetet i länet, vilken har legat till grund för aktiviteter som genomförts och processer som startats under pilotprojektets tid. Detta innefattar i huvudsak kommunbesök, dialoger, samverkanskonferenser, utbildning i folkhälsa och folkhälsoarbete, studiebesök till Bodö samt förankring och framtagande av en avsiktsförklaring för en god, jämlik och jämställd hälsa.Resultat: Pilotprojektet har bidragit till goda förutsättning för att etablera en samordningsstruktur som stimulerar och förtydligar det gemensamma regionala folkhälsoarbetet, vilket i sin tur stärker det lokala folkhälsoarbetet. Arbetet med pilotprojektet har lett till ökad kunskap hos beslutsfattare och andra aktörer om betydelsen av och förutsättningarna för att bedriva ett folkhälsoarbete med fokus på jämlikhet. Pilotprojektet har även bidragit till att utveckla relationer, kunskaper, drivkrafter, engagemang och motivation hos länets folkhälsoaktörer. Med utgångspunkt i de lokala behoven har pilotprojektet utvecklat arbetssätt för samordning av lokalt och regionalt folkhälsoarbete. Detta arbetssätt kan sammanfattas i en modell som möjliggör för aktörer att bidra till, få hjälp med och samarbeta efter de egna förutsättningarna i syfte att stärka både det lokala och regionala folkhälsoarbetet. Västerbottensmodellen består av följande komponenter:Lyssna – ett behovsorienterat förhållningssätt: Lokala perspektiv och behov styr hur samverkan fungerar och utvecklas för att olika aktörer tillsammans ska kunna bidra till ett gott folkhälsoarbete utifrån sina förutsättningar.Lita på varandra – en tillitsbaserad arbetsprocess: Det behovsorienterade förhållningssättet karakteriserar såväl de externa som det interna arbetsprocesserna med en kontinuerlig dialog mellan lokala och regionala aktörer.Göra – strukturerade metoder: Gemensamt utformade och väl förankrade metoder ger goda förutsättningar för att kunna etablera en samordningsstruktur för lokalt och regionalt folkhälsoarbete.När pilotprojektet tar slut behövs en samordnade funktion som tar vid helheten av det pilotprojektet stått för, varför pilotprojektet tog initiativ till att bilda Forum för folkhälsa i Västerbotten. Intentionen är att Forum för folkhälsa i Västerbotten ska förvalta och utveckla de metoder och arbetssätt för regional samordning som pilotprojektet arbetat fram, vilka inkluderar: kunskapshöjande insatser, dialoger, överenskommelser, samverkanskonferenser och informationsspridning. Förhoppningen är att Forum för folkhälsa i Västerbotten kommer utgöra ett nav för samverkan som både främjar och stödjer dialog, informations- och erfarenhetsutbyte, utveckling och utbildning och bidrar till uppföljning av folkhälsoarbetet i länet.
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