EIGE-2021 Gender Equality Index 2021 Report: Health
The working environment for those in paid jobs often causes chronic stress and may lead to burnout and depressive symptoms. Workers suffering from prolonged stress can simultaneously develop serious physical health problems such as cardiovascular disease or musculoskeletal conditions. With entrenched gender segregation in the labour market, women’s over-representation in precarious work and the continued difficult articulation between paid and unpaid work, work-related stressors are likely to have different impacts on women and men. For example, women constitute 70 % of the global health workforce and are highly visible on the frontlines of the COVID-19 pandemic. Their working hours, shift assignments and great exposure to infection create extremely high levels of distress and risk burnout (WHO, 2020c). The effects of the COVID-19 pandemic on the mental health of workers, especially those deemed ‘essential workers’, are likely to be profound and are analysed in Section 9.2.2.
In Europe, severe forms of burnout are rather infrequent, at below 5 %, based on diagnostic criteria, while more moderate and mostly self-assessed forms of burnout are reported by between 15 % and 25 % of respondents in different cross-cutting studies(Eurofound, 2018b). The same Eurofound study found that women are more likely than men to be affected by burnout in Belgium, Czechia, Germany and the Netherlands. In other countries, for example Austria, Finland and Slovenia, there appears to be no significant gender gap. However, women and men may experience burnout differently. For example, women tend to feel more emotionally and physically exhausted and overextended at work, whereas men become more depersonalised, which can manifest in them distancing themselves psychologically from clients and co-workers (Purvanova and Muros, 2010). Contrary to expectation, occupation does not moderate gender-specific patterns of burnout.
A substantial proportion of the European working population – 22 % of women and 19 % of men – report depressive symptoms, and it is suggested that work-related risk factors for depressive symptoms are gender specific (Ardito et al., 2014) . Among women, high psychological and intermediate emotional demands significantly enhance the risk of depressive symptoms. Conversely, high levels of decision authority and support from managers, intermediate support from colleagues, a positive social climate, and job rewards and security are protective. Among men, the relative risk of depressive symptoms is significantly raised by exposure to intermediate psychological demands and high pressure to hide emotions. However, a variety of work, opportunity for skills use and development, support from colleagues and managers, and job rewards and security greatly reduce the risk.
Work–life balance tensions
Work–life balance and conflict are other important aspects affecting the mental health of the working population (Eurofound, 2017, 2018b). Both the work-to-family conflict, namely spending extra time at work and reducing time with family, and family-to-work conflict, namely domestic obligations affecting work hours, are strongly correlated with burnout (Purvanova and Muros, 2010). A meta-analysis demonstrates that women are more likely to experience family-to-work conflict, while men more often face work-to-family conflict (Byron, 2005) . OECD statistics on time in paid and unpaid work show that men spend more time in paid work. Women, in contrast, spend more time in unpaid work, but also spend more time in total on work, paid and unpaid combined.
EIGE (2021d) has highlighted the continued burden of unpaid care on women, whether or not they are employed. It has also shown that women in precarious jobs face higher time demands than women in stable work. However, the demands of unpaid care are rarely analysed as a social determinant of mental health. Of 1 522 papers covered in a recent gender-sensitive literature review of the impact of precarious jobs on mental health, none considered the distribution of domestic work (Valero et al., 2020).
Gender disparities in unpaid care widened during the COVID-19 pandemic. The closure of schools, childcare and other services put women with care responsibilities under particular strain (EIGE, 2021d). For lone mothers, the loss of childcare support and related economic fallouts, such as income loss, have been especially consequential in terms of physical, economic and mental health (Bauer et al., 2021).