Tag Archives: Understanding Society

Constriction worker

Is temporary employment bad for your health?

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How is the health of those in insecure jobs affected by their working lives? Rachel Sumner and colleagues* have discovered some types of work may be just as strongly linked with poor health as unemployment is.

It’s long been acknowledged that there’s a link between unemployment and poor health. A recent Government Green Paper put it starkly:

“People who are unemployed have higher rates of mortality and a lower quality of life. This is an injustice that we must address.”

But is any job really better than no job? Or could some types of employment actually be linked just as strongly to poor health?

We looked at the issue using data from the Understanding Society study, which took blood samples from more than 4500 people aged between 16 and 64 who were either working or unemployed in 2010 and 2011– we excluded those who were retired, homemaking, not working due to incapacity or in education.

Overall, 7.6 per cent of our sample were unemployed. Amongst the employed, 81.8 per cent were permanently employed, 5.3 per cent were temporarily employed and 12.9 per cent were self-employed.

Health indicators

These samples were used to show whether the study participants had raised levels of fibrinogen or C-reactive protein (CRP), both of which are inflammatory markers and are associated with increased risk of heart disease. Healthy lifestyles decrease CRP levels, while obesity, physical inactivity and smoking increase them.

We compared the levels of these markers in those who were unemployed, permanently employed, temporarily employed and self-employed. We took into account a range of individual, social and health factors which might also influence the levels of these markers.

We didn’t find links between employment status and levels of CRP – but we did find links with fibrinogen.

We looked at how the levels of fibrinogen in different types of employee compared with those who were unemployed. And while those in permanent jobs or self-employed had lower levels of this marker, those in temporary work had similar levels to the unemployed.

So, not all types of work are equally beneficial in health terms – and in particular, temporary work would seem to be linked with worse health than other types. Indeed, in health terms we may actually be just as well off being unemployed as we are in an insecure job.

Why does this matter? It matters because less stable types of employment have grown in recent decades, with many workers employed on fixed-term contracts and experiencing uncertain job conditions. This has already been shown to have negative psychological consequences.

And since the recent global recession, which happened just before our data was collected, both unemployment and temporary employment have expanded. The European Union has a higher temporary employment rate than the OECD average  – 14.2 per cent compared with 11.2 per cent in 2016.

Levels of temporary employment in the UK are lower than the EU average – just six per cent in 2017 and four per cent in 2019  – but temporary employment has become more common since the financial crisis, particularly among young people. The rate of young people in the UK going into precarious employment has already resulted in poorer mental health.

Lessons for policymakers

If temporary employment is associated with an increased risk of mortality then earlier research which has simply compared unemployment with employment has not captured the complexities of the situation.

In conclusion, our findings would suggest there is little difference between the health effects of temporary employment and unemployment, using these particular indicators.  And given the continuing rise of precarious modes of employment across developed countries, this has significant implications for public health. Policymakers should encourage employers to expand the use of permanent contracts.

Unemployment, employment precarity, and inflammation, by Rachel C. Sumner, Rachel Bennett, Ann-Marie Creaven and Stephen Gallagher, is published in Brain, Behavior and Immunity.

Rachel Sumner and Rachel Bennett are based at the School of Natural & Social Sciences, University of Gloucestershire, United Kingdom; Ann-Marie Creaven and Stephen Gallagher are at the Health Research Institute, Department of Psychology, University of Limerick, Ireland.

Woman doing housework

Domestic work – why do women still do the lion’s share?

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A recent international report suggests men need to increase their time spent doing unpaid care work by a minimum of 50 minutes per day in order to do 50 per cent of the work. The report calls for bold measures to help all men do their fair share of this work by 2030 and thus promote gender equality. So what do we know about how modern couples in the UK divide unpaid domestic work and the drivers behind that? A new study from Anne McMunn at the ESRC International Centre for Lifecourse Studies at University College London investigates why greater workplace equality has not yet been matched by a more equitable division of labour at home.

Some studies suggest education is the key to equality within the home – that women with better education, and therefore greater earning power, are in a stronger negotiating position when it comes to housework.

But that theory doesn’t entirely hold water – it’s clear that even when women are better educated than their partners, they’re still likely to bear the heaviest burden when it comes to domestic labour.

Similarly, it’s been suggested that domestic work is divided according to time available – so when a male partner works longer hours, the female does more housework. But again, the reverse doesn’t hold true and women who work more hours outside the home still do more housework too.

Longitudinal study

We used the UK Household Longitudinal Study, which has surveyed around 40,000 households since 2010, to examine a number of hypotheses about why greater workplace equality hasn’t been matched by a more equitable division of labour at home.

Does a shared belief in equality make a difference? As men are often asked, in the modern world, to do more domestic labour, are their beliefs a driving factor? What is the role of education, if any, in how couples divide up these tasks? If one partner is resistant to sharing the work, is the other empowered by having a higher level of education?

Using opposite-sex couples in the study who were aged 16-65 and had answered the relevant questions, gave us a sample of 8,513 couples. We looked at four types of work to give us a full picture of the labour those couples did: housework, paid employment, childcare and adult care – for instance, caring for an older relative.We used a technique that allowed us to see what groups emerged from the data to see how contemporary British couples share or divide these different types of work.

We also categorized our couples according to their answers to a series of ideological questions – were they both similarly traditional, egalitarian or middling, or was one partner more egalitarian while the other was more traditional?

Education levels

Then we looked at their levels of education – were both equally educated, was the woman more highly educated or was the man more highly educated?

Very few of the couples shared work equally. In just six per cent of couples, the woman was the main earner while domestic tasks were shared quite evenly. These women were likely to be more highly-educated than their partners. In a further one per cent of couples  the man remained at home and did more than 20 hours’ domestic labour. Even in those cases, around two thirds of the women also did some domestic work.

However, these stay-at-home men were quite likely to be caring for an adult – four out of ten of them provided more than 20 hours’ care per week. Only 30 per cent of female-earner couples had children under 16 living at home, and of those just a quarter of men had the main responsibility for childcare. Men in this group did more housework than in some other groups, but they still did less than their partners.

Almost half (49 per cent) of couples were dual-earner couples in which both members of the couple tended to be employed full-time but these couples were less likely than traditional couples to have children at home.

Traditional divisions of labour

About 30 per cent of couples were traditional in the division of work with men working full-time and women not employed or working short hours. These couples tended to have dependent children at home and women in this couples did large amounts of housework, and in a small minority of women in these couples doing over 20 hours of housework per week.

A small group of couples (two per cent) also emerged in which women worked part-time and men worked very long hours at 60 hours per week or more. These women had more responsibility for care, and more for housework.

The third most common group, at 13 per cent, was a slightly older group of couples in their fifties or early sixties, in which neither were working full-time and there was little or no care responsibility. Women in these couples did relatively high levels of housework, suggesting that these couples may have previously followed a traditional gender division of work.

Those couples who didn’t have shared egalitarian beliefs – either both had traditional views or one did but the other didn’t – were more likely to fall into a more traditional work pattern.

What about education?

Men who were better-educated than their partners were more likely to fall into the traditional working patterns, and men with lower educational qualifications than their partners were more likely to stay at home. And these traditional patterns were even more likely to pertain when the man was more highly-educated and both shared traditional views.

So, education makes a difference, and so does a shared ideology. But it is important to note that very few men, in any category, did longer hours of domestic work than their female partner. So when it comes to housework and caring, gender equality remains rare and gender norms remain strong. 

Our beliefs may form a starting point for shaping our behavior, but that’s only a starting point, and not a solution. The ‘bold’ 50 minutes for 50 percent suggestion in the State of the World’s Fathers report, certainly seems to be grabbing the bull by the horns and, like our research, points clearly to the need for urgent change in terms of who does the daily care work in our homes. That is if we genuinely want a significant shift in power relations between men and women and to bring about gender equality.

Gender divisions of paid and unpaid work in contemporary UK couples is research by Anne McMunn, Lauren Webb, Elizabeth Webb and Amanda Sacker is published in the journal, Work, Employment and Society.

 

Is working flexibly good for your health?

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Flexible working is considered good practice – and in England, most workers have the right to apply to work flexibly after they’ve been in their job six months. But what do we know about the benefits? A new study by Tarani Chandola and colleagues used biological measures to look at differences in stress markers among workers with reduced hours and those without.

In recent years many employees have been able to alter their work patterns to fit in with childcare and other responsibilities. Typically, this can mean working part-time, job-sharing, only working during school term-times or working from home some of the time.

It’s assumed this should help to relieve stress. But until now, we didn’t know whether this was necessarily the case. After all, there could be down-sides – for example working at home can mean a blurring of the boundaries between work and family time, part-time working can be a barrier to promotion and job-sharing can bring its own tensions.

Until recently we had to rely on workers’ own reports of how they felt in order to judge this interplay between work, family life and stress. But now a number of social surveys have begun collecting samples which allow us to measure biological changes which can indicate stress, too.

This is known as ‘allostatic load’ – when we’re repeatedly subjected to stress or trauma, this can lead to chronically heightened levels of stress hormones. And that is associated with all sorts of long-term health problems, such as heart disease, type-2 diabetes and depression.

We were able to use data from participants in the Understanding Society study, which began in 2009 and which follows more than 60,000 adults in 40,000 households. As well as responding to detailed questionnaires, many of them have been visited by nurses who have taken physical measurements and blood samples.

Blood-based markers

As well as blood-based markers such as insulin growth factor 1 and cholesterol, their pulse rate, blood pressure and waist-to height ratio were also measured.

After taking out those who weren’t employed, who didn’t have the nurse visits or for whom some measurements were missing, we had a sample of a little over 6,000 people.

All those people had been asked whether flexible working arrangements were available at their workplace, how many hours they worked and whether they were the primary carer for their children.

We categorised working hours into three groups, with different levels for men and women because they tend to have very different working patterns. So women were grouped into those working less than 24 hours per week, more than 25 hours and more than 37 hours; while men were grouped into those working less than 37 hours, 37-40 hours and more than 40 hours.

Unsurprisingly, we found more women than men had made use of flexible working  arrangements – almost no men in our sample were the main carers for two or more children.

Chronic stress

There were particularly high levels of biological chronic stress markers among women with childcare responsibilities who worked more than 37 hours per week. Those with similar childcare responsibilities but working fewer than 25 hours per week didn’t have any measurable effect on their stress levels.

Both men and women who had access to, and made use of, reduced-hours flexible working had lower levels of biological stress markers than those who didn’t have flexible working.

We found these types of reduced-hours arrangement were more common among those in lower-paid occupations, especially among men, and among older workers of both genders.

Other types of flexible working arrangements, such as working from home, were more common among those from more advantaged social groups. But we didn’t find any association between these types of working and lowered levels of stress.

So, what has our study told us? We’ve learned a good deal about the complex relationships between social and biological factors in our lives. And, crucially for policymakers, we can see that it’s particularly important for women with childcare responsibilities to be able to access shorter working hours when they need to. For employers, this isn’t just a matter of logistics and of ensuring a stable and happy workforce – it’s also a major factor in ensuring that workers live longer and healthier lives.

Are Flexible Work Arrangements Associated with Lower Levels of Chronic Stress-Related Biomarkers? A Study of 6025 Employees in the UK Household Longitudinal Study, is research by Tarani Chandola (University of Manchester and UCL), Cara Booker, Meena Kumari and Michaela Benzeval (University of Essex) and is published in Sociology.

Woman worker

Anti-social working hours: Are they making women depressed?

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The rise of globalisation and the 24/7 economy are fuelling demands for people to work long hours and weekends.  But what’s the evidence about how these ways of working link with depression? Gill Weston and colleagues from the International Centre for Lifecourse Studies in Society and Health at UCL and Queen Mary University of London found such working conditions are linked to poorer mental health in women. 

Across the globe, the effects of overwork are becoming apparent.  In eastern Asian countries the risk of death due to overwork has increased.  In the UK, work-related stress accounts for millions of lost working days every year.  

Within the EU, a significant proportion of people have to work unsociable hours – with nearly a quarter working most Saturdays and a third working at least one Sunday a month.  But despite this, there isn’t much clear evidence about the links between work patterns and mental health. 

Some studies have found a connection between unsociable work patterns and depression.  But many of the studies only focused on men, some only looked at specific types of worker or workplaces and few took account of work conditions such as whether workers had any control over how fast they worked.  

To address these gaps, we set out to look for links between long or irregular hours and depression using a large nationally representative sample of working men and women in the UK.  We particularly wanted to look at whether there were differences between men and women because research has shown that work is organised, experienced and rewarded differently for men and women, and because men and women react differently to overwork and time pressure. 

We used data from Understanding Society, which surveys people living in 40,000 households across the UK.  In particular we focused on information about working hours, weekend working and working conditions collected from 11,215 working men and 12,188 working women between 2010 and 2012.  They had completed a questionnaire designed to study levels of psychological distress.

Who works the most? 

We found men tended to work longer hours in paid work than women, and having children affected men’s and women’s work patterns in different ways: while mothers tended to work fewer hours than women without children, fathers tended to work more hours than men without children.  

Two thirds of all men worked weekends, compared with half of all women.  Those who worked all or most weekends were more likely to be in low skilled work and to be less satisfied with their job and their earnings than those who only worked Monday to Friday or some weekends 

Which workers have the most depressive symptoms? 

Women in general are more likely to be depressed than men, and this was no different in our study. 

Independent of their working patterns, we also found that workers with the most depressive symptoms were older, smokers, on lower incomes, in physically demanding jobs, and who were dissatisfied at work. 

Are long and irregular hours linked to depression? 

Taking these findings and other factors into account, when we looked at the mental health effects of work patterns on men and on women, the results were striking: while there was little or no difference in depressive symptoms between men who worked long hours and those who did not, this was not the case for women.   

Those women who worked 55 hours or more per week had a higher risk of depression than women working a standard 35-40 hour week.   

Similarly weekend working showed differences for men and women.  Compared to workers who only worked on weekdays, men who worked weekends also had a greater number of depressive symptoms, but only if they had little control at work or were dissatisfied with work.  Whereas for women,  regardless of their control or satisfaction, working most or all weekends was linked to more depressive symptoms. 

Why might women suffer more than men while working these antisocial hours?  

There might be a number of reasons why women might be more affected than men: 

  • Women who work long hours are in a minority – just four per cent of them in our sample worked 55 hours or more per week. This may place them under additional pressure. 
  • Women working longer hours tend to be in male-dominated occupations, and this may also contribute to stress. 
  • Women working weekends tend to be concentrated in low-paid service sector jobs, which have been linked to higher levels of depression. 
  • Many women face the additional burden of doing a larger share of domestic labour than men, leading to extensive total work hours, added time pressures or overwhelming responsibilities.  

What should be done about these risks? 

Our findings should encourage employers and policy-makers to think about how to reduce the burdens and increase support for women who work long or irregular hours – without restricting their ability to work when they wish to.  More sympathetic working practices could bring benefits both for workers and for employers – of both sexes. 

Long work hours, weekend working and depressive symptoms in men and women: Findings from a UK population-based study by Gill Weston, Afshin Zilanawala, Elizabeth Webb, Livia Carvalho, and Anne McMunn is published in the  Journal of Epidemiology and Community Health, which is published by the BMJ. 

Being a carer: a sizeable problem

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Millions of people combine work with caring responsibilities – looking after an older relative, a disabled child or a partner, for example. But what are the effects on the health of those who do this? Rebecca Lacey and colleagues from the ESRC International Centre for Lifecourse Studies at UCL have found that younger women and those who juggle working and caring are at higher risk of being obese.

The number of people who care for others without pay is huge – and it’s growing. In the United Kingdom there are more than seven million such carers – around one in five adults. About six in 10 of them are women.

We know from existing studies that becoming a carer can mean having to stop work – but an ageing society, extended working lives and cuts in social care funding mean those doing this unpaid caring are also increasingly often juggling their caring responsibilities and paid work.

Caring is linked to behaviour which leads to health risks, as well as to poorer health. Carers can suffer from the deterioration of their relationships with those they care for – particularly when the person needing to be cared for has dementia. They have to juggle caring and other responsibilities, resulting in little time for themselves: this means they may have less time to exercise and to eat healthily. They can also suffer additional financial burdens. All this can lead to measurably higher levels of stress – for example, research has shown that carers have higher levels of cortisol, which can cause the body to lay down fat. We wanted to know more about whether particular groups of carers were at increased risk of being obese.

We were able to use a major study, Understanding Society, which has followed a representative sample of 40,000 UK households since 2009 and which is also linked to another study, the British Household Panel Survey, which first started in 1991.

This enabled us, for the first time, to look at obesity amongst UK carers from the age of 16 onwards: previous studies had only looked at older carers or carers of those with specific conditions such as dementia.

We had information on 9,421 participants who had also been visited by nurses for health checks between 2009 and 2012, of whom 1,282 were carers. We were able to look at factors such as Body Mass Index (BMI) alongside whether participants had an illness or disability, their education, occupation, household income, socioeconomic position, partnership status and whether they were parents. We looked at how many people they cared for, and for how many hours in the week. And we also looked at whether they were also doing paid work, and if this was full or part-time.

Nurse visits were used to measure participants’ weight, percentage of body fat and BMI.

Women as carers

Roughly in line with national figures, we found women were more likely to be carers and to put in more hours of care each week. Female carers were more likely than their male counterparts to have children at home and also to be working outside the home – this may be because male carers tend to be older.

When we looked at whether men’s caring was linked to obesity, we did find an association – men who were carers had higher BMIs and larger waists. However, once we had taken differences in age into account we didn’t find this statistically significant.

But when we looked at women, the story was rather different. In contrast to men, women who were carers were significantly more likely to have larger waists or a higher percentage of body fat. And there was a particularly strong effect when it came to women who combined caring with full-time work: amongst young women aged 16-44 who were in full time work, those who were carers had waists 4cm larger, on average, than those who were not carers. Those who were caring and working beyond the age of 65 were also larger, with higher proportions of body fat and bigger waists.

Why is this? Why would women’s health potentially suffer a greater adverse effect than men’s from being a carer? It seems the strains on them may be greater – younger women may be working outside the home and may also be caring for children, for instance. They may lose touch with friends who have more freedom to enjoy leisure time. Carers are likely to have less time to spend exercising or to prepare healthy and nutritious meals – and those combining several caring roles with working life are likely to be particularly hard-hit.

This matters, not least because the scale of the issue is so great – and because the UK relies so heavily on its citizens to look after their own – carers have been estimated to save the UK economy £132 billion per year. We need to make this largely hidden army of unpaid carers a public health priority.

Informal caregiving and markers of adiposity in the UK Household Longitudinal Study is research by Rebecca Lacey, Anne McMunn and Elizabeth Webb of the ESRC International Centre for Lifecourse Studies, University College London.

Unretirement: can it be a positive story for all?

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“When I was sitting around at home I would just get grumpy. I’ve also lost five stone since working here. This is like a vitality camp for me.” Retired British Transport Police inspector Brendan McCambridge, 56, interviewed in The Telegraph, describes how his new role at Waitrose has improved his life. He is one of the one in four retired British people who return to paid work, a phenomenon called “unretirement”. New research, led by Dr Loretta G. Platts from Stockholm University’s Stress Research Institute, explores who ends up unretiring. In this blog post, she considers the implications for individuals, business and policy of retired older people returning to paid work.

Retirement can be an abrupt and one-way change marking the end of paid work and the start of a time of leisure. But people’s lives often don’t look like this. People may gradually retire over a period of time, or even unretire, returning to paid work after retiring. We found that around one in four retirees in the UK returns to paid work, mostly within five years of retiring.

Our information came from the longitudinal Understanding Society data and its predecessor the British Household Panel Survey. We followed more than 2000 50–69-year-olds through the 1990s and 2000s. Participants were defined as unretiring if they reported retiring and later returned to paid employment, or began full-time work following a period of semi-retirement.

While all sorts of people unretire, men are more likely to unretire than women, as are people in good health and those with post-16 qualifications. Unretirees are also more likely to have a partner in paid work. After ten years, a retiree’s chances of taking up paid work are low.

What motivates unretirement?

Unretirement was a positive experience for Brendan McCambridge. Having a job helps to stay mentally and physically active, provides a meaningful activity, and unretirees often appreciate the social side of paid work. Some may appreciate the extra money earned which supplements a pension and provides funds for little extras. For others, earning money is an important part of the decision to unretire.

Our findings suggest that financial factors play a role in the decision to return to paid work. Retirees paying off a mortgage are more likely to unretire than those who already own their home outright. Unretirees may wish to prepare financially for retirement or to supplement a pension. With a basic state pension of £122.30 per week for people who retired before 6th April 2016, some people may have found a new job because they could not afford to retire.

Former Pensions Minister Steve Webb, now director of policy at Royal London, contends that some retirees may have little other option than to get a job. In an interview for People Management, Webb noted that although many of those heading back to work after retirement do so because they “miss the stimulation and social contact”, there is a “real danger” that a whole generation of people will be unable to retire in the first place because they have not managed to save a big enough pension pot.

He says: “If employers do not address this issue they could find themselves with an unhappy older workforce that does not want to work but cannot afford to stop.”

Why retire and then unretire?

Some people may unretire as a result of finding out that they like being retired a lot less than they thought they would. Researchers call this a “retirement shock”, in which recent retirees, just like Brendan McCambridge, discover that they do not like their new lifestyle.

Others may have known all along that they wanted to remain in paid work, but were unable to. More than one million people over 50 are out of work for reasons beyond their control and would like to be in paid work if the appropriate opportunities were available. Some people may be forced out of work directly or indirectly as a result of age-based stereotypes, in particular through not being offered training programmes to learn new skills, or from their updated skills being undervalued.

In their second Missing Million report, Business in the Community has argued that far too many older people are being denied the chance to enjoy meaningful employment in later life and calls for stronger age discrimination legislation to tackle this.

Employers of older people also often deny them the flexibility they require to stay in paid work. Workers aged between 50 and 69 years are more likely than other age groups to want to work fewer hours than they currently do, even if this were for less pay. Around 8 per cent of workers in their 50s are working more than 45 hours per week while also being in ill health. Such older workers, locked into working long hours, may retire from jobs because they do not offer sufficient flexibility of working times.

Retirees may then take a more suitable job if it comes up, or negotiate more suitable working times later on if their former employer asks them to come back. Dr Jill Miller, diversity and inclusion adviser at the Chartered Institute for Professional Development believes that simple adjustments to working times or job roles could be the key to employers attracting and retaining a “significant talent pool” of older workers who can contribute to the success of the organisation.

Does everybody get to unretire if they want to?

While people in financial straits may be wanting to unretire, we found they did not necessarily manage to. People who were struggling to make ends meet were not more likely to unretire than people in a more comfortable financial situation.

Similarly, those who had lower earnings before retirement were not more likely to unretire. The reason is probably that it is harder for people in a precarious financial situation to find a suitable or good quality job.

These findings are worrying in terms of the broader picture of inequalities in later life. If those retirees who most need to supplement their incomes in later life are not able to find suitable paid work, unretirement may be part of processes that increase inequalities in income between older people.

The findings are also worrying in the context of skills shortages currently faced by British industry, which are predicted to be exacerbated over the coming years. By 2022, the skills gap is expected to reach 7.5 million vacancies. Government and business should not forget about the experience and skills of recently retired workers who are often ready and keen to be re-engaged in the workforce. These workers may need more support and legislation to protect and promote their rights to work more flexibly to take into account their preferences and also the fact that they may be caring for grandchildren and other family members.

Specifically, the government could improve flexible working legislation by providing employees with the right to request flexible working from the start of the job application process, rather than waiting 26 weeks from the beginning of employment. Since older employees are less likely to be offered training, and are less likely to take it up, employers could monitor access to training and development by age as well as proactively offering training to employees and being open to additional training requests.

Where older people manage to find new jobs, it is a result of their own efforts and networks, and not because they accessed effective support. Older people reported in focus groups that Job Centres in particular provided poor guidance and assistance. Government could consider how to develop age-appropriate support services and guidance in Job Centres. Both government and employers could offer mid-life career reviews.

In the long term, we need to work towards a society in which unretirement becomes a positive story for all. Business and wider society stand to benefit from the ambition, experience and skills older people bring to the labour market. For financial and other reasons, many older people want to be in paid work. Currently, they are all too often left out.

Returns to work after retirement: a prospective study of unretirement in the United Kingdom is research by Loretta Platts, Laurie Corna, Diana Worts and Peggy McDonough and is published in Ageing and Society.

Photo credit: Scott Lewis

Woman warehouse worker

Out of work and overweight: Think again.

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There’s a widely held preconception that people who are out of work are overweight, perpetuated by the media and, indeed, reinforced by some academic studies. But recent robust evidence throws a whole new light on things and indicates that unemployed people are in fact much more likely to be underweight, and less likely to be overweight, than their peers who have not recently been unemployed. Amanda Hughes from the Institute for Social and Economic Research explains how she came to question narratives about benefit claimants being lazy and overweight and go on to undertake research she believes provides a more accurate picture.

While I was doing my PhD, I volunteered at a foodbank, and noticed that there were more people coming in who were painfully thin than too heavy. Some had not eaten that day or the day before. Others had walked for two hours to get there, because paying for a return bus journey was out of the question.

Of course, not all people who are out of work turn to food banks, and not all people who turn to foodbanks are unemployed. But that experience got me thinking: have researchers and public health officials been so concerned with obesity that they have missed a crucial part of the story? If weight loss or weight gain can occur during unemployment depending on personal circumstances, might there be an overlooked ‘U-shaped’ association of unemployment and body weight, with excess obesity and excess underweight among jobseekers?

We know that risk of dying is higher for jobseekers than for employed peers, and it is often assumed that increased overweight and obesity among jobseekers plays a role. But studies on the relationship of unemployment and body weight have been inconclusive; some document weight gain with unemployment, but others suggest weight loss. However, previous studies have compared only average effects – average change in body weight following job loss, or average differences between unemployed people and controls, and may have missed a more complicated ‘U-shaped’ association.

Working age BMI

Using Understanding Society, a longitudinal, nationally representative survey of more than 40,000 UK households, my colleague Meena Kumari and I were able to look at the BMI (body mass index) of 10,737 working-age adults between 2010 and 2012.

What was different about our study, was that we did not assume unemployment would impact BMI in the same direction for everyone. Rather, we allowed for a simultaneously raised risk among jobseekers of both underweight and obesity, by comparing the probabilities of being underweight, overweight, and obese between current jobseekers, recent jobseekers, and people who had not been unemployed since the start of the survey (the control group). To isolate the impact of unemployment itself, we took into account other factors such as demographics, chronic health conditions and mental health, smoking and physical activity.

A small proportion (0.7 per cent) of the people in our study who were employed were classed as underweight (i.e. had a BMI below 18.5). But for those in our sample who were unemployed, the proportion shot up to almost 4 per cent. This pattern remained when we took into account factors such as their education, gender, smoking, overall health, physical activity and alcohol consumption.

Certain groups were especially at risk: there were more extreme effects for longer-term unemployed people, for men, and people from lower-income households, suggesting household reserves or the support of family members may act as a sort of buffer against weight-loss effects. At the same time, currently unemployed people were much less likely to be overweight than peers who had not recently been unemployed (29 per cent v 40 per cent).

We did find that unemployed people were more likely to be obese, perhaps suggesting changes in dietary quality following unemployment towards energy-dense but nutrient-poor foods. However, this was only the case for non-smokers, which might reflect competing priorities between tobacco, food and other essentials for smokers on severely restricted budgets.

Quantitative evidence

Together, these results point to a complex picture in which jobseekers, depending on the complexities of individual lives, are at increased risk of both underweight and obesity, each with their own associated health risks.

The elevated underweight and reduced overweight among current jobseekers are quantitative evidence that many unemployed people are not eating enough in simple caloric terms. Despite the political importance of this question, evidence of this effect has so far been fairly anecdotal.

Our results make an important contribution to research trying to explain the increased risk of chronic illness and mortality for unemployed people – suggesting that, at least in contemporary Britain, being underweight may contribute to that much more than previously realised.

At the very least, I hope our evidence will be used to challenge preconceptions and debunk myths about unemployment. It has implications for the way politicians, journalists and the wider public perceive unemployment, and for anyone concerned with the health effects of being out of work.

Unemployment, underweight and obesity: Findings from Understanding Society is research by Amanda Hughes and Meena Kumari at the Institute for Social and Economic Research at the University of Essex, and published in the journal Preventive Health.

You can also read an article about this research in The Guardian.

Photo credit: At Work in the Capital Area Foodbank Warehouse, Geoff Livingston

Having any job at all is better than being unemployed, right?

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“Bad work just doesn’t fit in 2017!” Those are the words of Matthew Taylor, head of the Government’s recent review of modern work practices, who has called on politicians to make “all work good.” In an interview with the BBC, Mr Taylor, said that, as well as being bad for productivity and the economy, poor quality jobs were bad for people’s health and well-being. Recent research from Tarani Chandola from the University of Manchester has added further weight to those claims, finding that unemployed people who move into poor quality work have worse health than their peers who remain out of work. He explains more about the research findings and how they challenge the idea that having any job is good for your health.

There is considerable evidence to show that being out of work isn’t good for our health and that being in work can bring us a range of benefits, not just financial. It follows, then, that a move out of unemployment and into work is likely to be good for us, but does that hold true if the job we go into is a bad one?

Using rich social, economic and health data from the UK Household Longitudinal Study (UKHLS), our research examined the stress levels of a group of unemployed people aged 30-75, some of whom moved into poor quality jobs, some into good jobs and some who remained unemployed.

We also looked to see if any other factors, including their health at the outset of our study, had any bearing on the likelihood of them moving into a poor or good quality job.

Twelve biomarkers

As well as physical measurements such as height, weight and blood pressure, and self-reported information on their physical and mental health, some participants in the study gave blood samples. These could be tested for a range of markers, high levels of which might indicate diabetes, heart or kidney disease, acute or chronic stress. In total, we had 12 separate biomarkers, providing us with a comprehensive picture of participants’ health and an overall measurement of their stress, something referred to as their allostatic load.

How much people earned, how secure their job was and their working environment were all considered, in order to get a sense of the quality of their employment. Participants were asked how satisfied they were at work, how anxious or worried they felt about their job, how much control they had at work and whether they thought they might lose their job in the coming 12 months.

The people studied were divided into four groups:

  • Remained unemployed
  • Employed in a good quality job
  • Employed in a job with one poor quality measure
  • Employed with at least two poor quality measures

Stress levels

When we looked at the stress levels of the different groups, a clear pattern emerged. Unsurprisingly, people who moved out of unemployment and into a good job had the lowest levels of stress. People who went from being unemployed to working in a bad job (with more than two poor quality job measures) had the highest stress levels. These were 1.5 times higher than for those people who remained unemployed.

We took into consideration a host of other factors that might have had some role in propelling an unemployed person into a good or bad job, but even when we looked at their health at the outset of the study, this did not really play a role, other than to note that the people in better health moved into both good and bad jobs. In other words it wasn’t simply that people already in poor health were moving into the worse jobs.

Although numbers for this research were relatively small, the methods and analysis were extremely robust and we can, with some confidence, challenge the widespread belief that any employment, even poor quality work, is better for our health and wellbeing than being unemployed.

The findings serve to illuminate research published by the RSA and Populus recently, showing that three out of four people think we should do more as a country to improve the quality of work. Even more telling was the contrast between the over two thirds who think we can make all work fair and decent, and the less than one in ten who think this is already the case.

Making good work matter

Mr Taylor makes the case that “good work matters” and the RSA’s social media campaign #GoodWorkIs is a laudable effort to engage the wider public in a discussion about what good work looks like.

However, he, like many others, has said that the “worst work status for health is unemployment”. Our research shows that’s not necessarily the case, and our findings, together with more research in this area, should be considered carefully as strategies are hopefully developed to make his call to “make all work good” a reality not a pipedream, especially in the current political climate.

Re-employment, job quality, health and allostatic load biomarkers: Prospective evidence from the UK Household Longitudinal Study is research by Tarani Chandola and Nan Zhang and is published in the International Journal of Epidemiology.

 

How travelling to work can work for you

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There can’t be too many commuters who aren’t now aware that ditching the car and walking to work is much better for them. Considerable evidence has shown that walkers and cyclists are likely to weigh less and be slimmer than their car commuting counterparts. What they may be less aware of is that ditching the car in favour of the bus, train or the tube could have nearly the same benefits. A programme of research by a team at the London School of Hygiene and Tropical Medicine and the ESRC International Centre for Lifecourse Studies, UCL has been taking a closer look at the benefits of being an ‘active commuter’. As researcher Ellen Flint explains, the findings point to some clear ways forward, not just for individuals, but for policy makers too.

Physical inactivity and being sedentary for large parts of the day are a leading cause of obesity and premature death. In England alone something like two thirds of adults do not meet the recommended levels of daily exercise. At the same time there are growing numbers of people commuting to work. In England and Wales that figure is around 24 million people, 67% of whom take the car.

The time of life when most adults become obese is in middle age, with 50-65 year-olds less than half as likely as young adults aged 16-29 to use public transport, nearly half as likely to walk to and from work and two thirds less likely to get on their bikes. So it’s this age group that we have focused on in our programme of research looking at the relationship between active commuting and obesity in mid life.

To help us do this, we have used information from a long term household survey called Understanding Society and a large study called UK Biobank.

Public transport benefits

Our first piece of research used Understanding Society and showed us that not just walking or cycling to work but even catching the bus or the tube are all linked to lower body weight and body fat composition compared with those who get to work by car.

7,534 BMI and 7,424 percentage body fat measurements from men and women who took part in the survey were used in conjunction with information about journeys to work.

Men who commuted via public or active modes had BMI scores around 1 point lower than those who used private transport, equating to a difference in weight of 3kg (almost half a stone) for the average man.

Women who commuted via public or active transport had BMI scores around 0.7 points lower than their private transport using counterparts, equating to a difference in weight of 2.5kg (5.5lb) for the average woman.

When it came to body fat, men who actively travelled to work (walking, cycling or public transport) had body fat that was roughly one per cent point lower than those who commuted by car, confirming the picture seen when looking at BMI.

What’s important to note here is that these differences are larger than those seen in the majority of individually focused diet and physical activity interventions to prevent overweight and obesity.

Second study reinforces

In work just published in The Lancet Diabetes and Endocrinology, we were able to use information from more than 70,000 men and 80,000 women aged 40-69.

More than 60% of these people commuted by car, with only 4 percent and 7 percent respectively reporting walking as their only method of commute and 4 percent and 2 percent cycling. Around one in five was an active commuter some or all of the time.

Except for those who mixed car and public transport, all other groups had significantly lower BMI and percentage body fat than those men and women who ONLY commuted by car.

The biggest differences were for cyclists and the results stayed strong even when we accounted for a wide range of other factors such as social and economic background, their general health and even whether or not they did exercise outside of their daily commute.

The men who cycled were around 5 kg lighter whilst women cyclists were on average nearly 4.5kg lighter than their car commuting counterparts.

Unsurprisingly, walking to work had the next biggest association with reduced obesity. Compared with their car commuting counterparts, men who walked to work were on average 3.0kg lighter; and women typically weighed 2.1kg less.

However, what was perhaps more interesting, and what also reinforced our interesting earlier findings from Understanding Society, was that even those who used a mixture of public transport and active methods of commuting still had significantly lower BMI and body fat percentage than those who commuted exclusively by car.

In fact, it was similar to those who only walked to work. Compared with car commuters, men and women who mixed public transport with some walking or cycling typically weighed 3.1kg and 2.0kg less, respectively.

Active commuting at heart of policy

Separately these two studies make interesting reading, but together they combine to make a powerful and growing body of evidence around the benefits of active commuting and do more than hint at potential interventions for policy makers.

There is now a clear case for the health benefits of active commuting to be taken into consideration by transport planners, town planners and urban designers.

Cities can be active by design and the more evidence that we have to confirm that people who commute actively really are lighter and have a healthier body composition, the more impetus there is for these health related outcomes to be at the heart of policy.

It is time to realise the untapped population health improvements potential of these big shifts we can make in how people travel to and from work.

Photo credit: Chris Rubberdragon