Long Working Hours and Health Status among Employees in Europe: Between-Country Differences

By Artazcoz, Lucía; Cortès, Imma et al. | Scandinavian Journal of Work, Environment & Health, July 1, 2013 | Go to article overview

Long Working Hours and Health Status among Employees in Europe: Between-Country Differences


Artazcoz, Lucía, Cortès, Imma, Escribà-Agüir, Vicenta, Bartoll, Xavier, Basart, Helena, Borrell, Carme, Scandinavian Journal of Work, Environment & Health


Artazcoz L, Cortès I, Escribà-Agüir V, Bartoll X, Basart H, Borrell C. Long working hours and health status among employees in Europe: between-country differences. Scand J Work Environ Health. 2013;39(4):369-378. doi:10.5271/sjweh.3333

Objectives This study aimed to (i) identify family responsibilities associated with moderately long working hours (41-60 hours a week); (ii) examine the relationship between moderately long working hours and three health outcomes; and (iii) analyze whether patterns differ by welfare state regimes.

Methods The sample was composed of all employees aged 16-64 years working 30-60 hours a week interviewed in the 2005 European Working Conditions Survey (9288 men and 6295 women). We fitted multiple logistic regression models separated by sex and welfare state regime typologies.

Results Married males were more likely to work long hours in countries with male breadwinner models whereas family responsibilities were related to long working hours among both sexes in countries with dual breadwinner models. The association between long working hours and health was (i) stronger among men in countries with male breadwinner models, primarily in Anglo-Saxon countries [adjusted odds ratio (ORadj) associated with working 51-60 hours of 6.43, 6.04 and 9.60 for work-related poor health status, stress and psychological distress, respectively); (ii) similar among both sexes in Nordic countries; and (iii) stronger among women in Eastern European countries.

Conclusions In the European Union of 25 members (EU-25), working moderately long hours is associated with poor health outcomes with different patterns depending on welfare state regimes. The findings from this study suggest that the family responsibilities and breadwinner models can help explain the relationship between long working hours and health status.

Key terms gender; family characteristic; psychological distress; socioeconomic factor; stress.

Although in recent years interest in health problems related to long working hours has increased, studies concerning the different areas of health are still scarce and have been focused on very long working hours, which are uncommon in Europe. The detrimental impact of extreme overtime work has often been demonstrated, but the unfavorable impact of moderately long working hours on health and well-being has not been consistently shown (1-6). Moderately long working hours and their impact on health have been related to family financial stress and the breadwinner role: in situations of family financial stress, breadwinners are likely to be forced to work long hours in order to increase the family income (7, 8). Therefore, apart from methodological reasons, the contradictory results of previous studies could be explained by different breadwinner models across countries.

Some studies have highlighted the crucial role of choice in determining a person's response, in terms of health and well-being, to working long hours (7-13). Two theoretical approaches have been proposed to account for the obligation to work long hours: consumerism and bargaining power (14). Consumerism may lead families to desire and expect high levels of consumer spending that traps some family members in situations requiring them to work long hours (8, 15). The importance of family financial stress, not only related to consumerism but also to other aspects such as low wages, has been identified as a reason for being forced to work long hours that can lead to poor health outcomes (7, 8). A review about long working hours in the UK reported that those who worked longer hours were more likely to (i) be men with children, (ii) have large mortgages or a high cost of living, and (iii) have a partner who either does not work at all or does not work full time (16). Bargaining power considerations suggest that where employers hold greater leverage over employees, as in the case of non-unionized workplaces, workers who receive low pay, have temporary contracts, or are in situations of economic vulnerability, are more likely to be forced to work long hours. …

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