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The contribution of employment and working conditions to occupational inequalities in non-communicable diseases in Europe

Lookup NU author(s): Dr Catherine McNamara, Dr Viviana AlbaniORCiD, Professor Clare BambraORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


© The Author(s) 2020. Published by Oxford University Press on behalf of the European Public Health Association.BACKGROUND: Social inequalities in non-communicable diseases (NCDs) are evident across all European regions. Employment and working conditions are important determinants of NCDs, however, few comparative studies have examined how these conditions contribute to health inequalities. This study therefore examines the association of non-standard employment and poor working conditions with occupational inequalities in multiple NCDs and whether there are differences by gender and across European regions. METHODS: We used cross-sectional data from 20 European countries for women and men aged 25-75 (n = 19 876), from round 7 of the European Social Survey. Data were analyzed for self-rated health (SRH) and 9 NCDs: heart/circulatory problems, high blood pressure, arm/hand pain, breathing problems, diabetes, severe headaches, cancer, obesity and depression. We used logistic regression models, stratified by gender, and adjusted rate ratios to examine whether occupational inequalities in NCDs were reduced after adjusting for non-standard employment and poor working conditions, across European regions. RESULTS: After adjustment, occupational inequalities were significantly reduced across all regions of Europe. Reductions were particularly large among the lowest occupational group and for poor-SRH, depression and obesity. For these conditions, reductions were in the range of 60-99%. CONCLUSIONS: Employment and working conditions are important determinants of occupational inequalities in NCDs. Labour market regulations should therefore be considered in the formulation of NCD prevention strategies.

Publication metadata

Author(s): McNamara CL, Toch-Marquardt M, Albani V, Eikemo TA, Bambra C

Publication type: Article

Publication status: Published

Journal: European Journal of Public Health

Year: 2021

Volume: 31

Issue: 1

Pages: 181-185

Print publication date: 01/02/2021

Online publication date: 18/11/2020

Acceptance date: 02/04/2018

Date deposited: 10/05/2021

ISSN (print): 1101-1262

ISSN (electronic): 1464-360X

Publisher: Oxford University Press


DOI: 10.1093/eurpub/ckaa175

PubMed id: 33207369


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