Health and work in adult women: population-based study in Campinas, Sao Paulo

Author(s)

Caroline Senicato

• Document type: Doctoral Thesis
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2015-04-09

Examining board members

Marilisa Berti de Azevedo Barros; Ana Bernarda Ludermir; Carlos Roberto Silveira Corrêa; Maria Yolanda Makuch; Moises Goldbaum

• Advisor: Marilisa Berti de Azevedo Barros

Abstract

Economic, political and social changes in recent decades have provided the expansion of female schooling and the increase of women's participation in the labor market. Today, approximately 55% of Brazilian women with 16 years old or over are economically active. However, women continue to have a central role within the family, especially with regard to the care of the children and the whole family as well as the performance of domestic activities, regardless of whether exercising a paid activity. In this context, we do not know about the possible associations between the insertion in the labor market and the health conditions of women. International review of longitudinal studies examining the effects of employment on health and women's well-being, found that usually the occupation does not produce adverse effects on women¿s health. However, there are few Brazilian studies about this subject. About these considerations, the aim of this study is to analyze the health, behavior and health-related quality of life among adult women, according to the insertion in the labor market comparing paid workers women and housewives. Health of household survey data was used in Campinas (ISACamp 2008/2009), conducted by the Centro Colaborador em Análise de Situação de Saúde (CCAS), Universidade Estadual de Campinas (Unicamp). It is a cross-sectional population-based study with a random sample by conglomerates, in two stages: census tracts and households. Data were 668 women with 18-64 years old, living in the urban area of the city of Campinas, and were analyzed using Stata 11.0 software, with svy command, which considers in analyzing the effects of the complex sample design of the survey process. The results of this thesis are presented in three articles. In the first study, "Health differentials between paid workers women and housewives in a Brazilian City" were evaluated differences in relation to health conditions and health-related behaviors among working paid and housewives. Associations between variables the chi-square test were estimated. Multiple regression model Poisson, with adjustment for age, education, number of children, marital status and household income per capita, was used to estimate adjusted prevalence ratios. We observed differences in health status, but no inequalities in behavior. Housewives had a higher prevalence of emotional issue of complaints (anxiety/sadness) and common mental disorders (estimated by the SRQ-20), the threshold of statistical significance, and lower prevalence asthma/bronchitis/emphysema and reporting violence (threshold of statistical significance). The second article, "Is there association between paid worker woman or housewife and health-related quality of life (SF-36)", assessed the quality of life related to health (HRQOL) in accordance with the inclusion in the labor market, and belonging to particular socioeconomic changes this association. The HRQOL was assessed by the instrument The Medical Outcomes Study SF-36 - Item Short Form Health Survey (SF-36). Simple and multiple linear regression models were made, adjusted by age, education, family income, marital status, number of children and number of chronic diseases. Being a housewife was associated with worse HRQOL, especially with mental aspects, but this association was modified by socioeconomic level. In the segments of intermediate and low level of education and per capita income housewives had a poorer HRQOL, but there were no differences at the higher level of education and family income per capita. In the third article, "Mental health of adult women: population-based study in Campinas, Sao Paulo", examined the association of common mental disorders (CMD) and insertion in the labor market and other socioeconomic and demographic varibles, behavioral and health, in adult women through the Self Reporting Questionnaire 20 (SRQ-20). A hierarchical Poisson regression model was created in three steps: socioeconomic and demographic variables, health conditions and behaviors. Women who had not paid occupation, those with low level of schooling, unmarried and with three or more children had higher prevalence of CMD and women who reported one or more chronic diseases, four or more health problems and who had been victims of violence, as well as those with poor diet quality (did not consume fruits, vegetables or vegetables daily) and who slept six or fewer hours per night. This study found that paid work was positively associated to women's health, especially to women's mental health. However, we can not disregard the "healthy worker effect": is most likely of physical and mentally healthy women are employed and keep working. However, the discussion of the present results with longitudinal study contributes to give greater support to the findings. Inequalities in HRQOL according to insertion in the labor market, especially as the mental aspects, with losses mainly housewives of worse level of schooling, reinforce the need to create more opportunities for the inclusion of women in the labor market and access to education. Housewives, low education, not having a partner and have three or more children in addition to the accumulation of diseases, inappropriate behavior and reporting of violence were factors associated with the presence of common mental disorders in adult women. Therefore, it is expected that the findings about the health conditions of working women and housewives can assist in developing social policies and health. In addition to macro-policies that provide access to education and conditions for insertion in the job market, such as the creation of kindergartens so that women can reconcile work and family, we need to upgrade the skills of primary care, such as family doctor, gynecologists and other professionals health staff in detecting and addressing women's mental health commitment boards, especially among housewives socially disadvantaged (AU)

• FAPESP's process: 12/07039-7 - Health and work in adult women: population-based study in Campinas, Sao Paulo.
• Grantee: Caroline Senicato
• Support Opportunities: Scholarships in Brazil - Doctorate