Elsevier

Social Science & Medicine

Volume 57, Issue 8, October 2003, Pages 1491-1503
Social Science & Medicine

Social role occupancy, gender, income adequacy, life stage and health: a longitudinal study of employed Canadian men and women

https://doi.org/10.1016/S0277-9536(02)00544-0Get rights and content

Abstract

Social role researchers are increasingly going beyond simply asking whether role occupancy is associated with health status to clarifying the context in which particular social role–health relationships emerge. Building on this perspective, the present study investigates the relationship between social role occupancy and health status over time in a sample of employed Canadian men and women who vary by family role occupancy, life stage, and income adequacy. Results indicated that compared to triple role women (defined as those who are married, have children living at home and are in the workforce), single and double role occupants in 1994/95 were significantly more likely to report poorer self-rated health and the presence of a chronic health condition in 1996/97. This relationship held true for women in varying life stage and economic circumstances. While family role occupancies were not as strongly related to the health status of men as women, one exception emerged: for older men, single and double role occupants reported significantly poorer self-rated health status than triple role men. Methodological limitations of the study are discussed, and the need for added specificity in the study of social roles and health status emphasized.

Introduction

The increasing number of women in paid employment, particularly married women with young children, is one of the most significant trends in the Canadian labour force in recent years (Statistics Canada, 2000). The employment of both parents outside the home has become the norm rather than the exception for two-parent households in Canada. A substantial proportion of employed Canadians appear to be feeling the strain of balancing work and home, particularly “triple role” occupants: a recent survey reported that 38% of married, employed women with children reported high levels of time stress, compared to 20% of “double role” women (married, working women without children) (Statistics Canada, 1999). The stresses and strains experienced by Canadians in general (and women in particular) in attempting to juggle multiple work and family responsibilities have become an increasingly frequent topic in the popular press (e.g., Chisolm, Doyle Driedger, McClelland, & Bergman, 1999).

The potential health implications of multiple role occupancy have also become the subject of much academic interest over the last decade. Several contrasting views have emerged in the research literature concerning the association between multiple role occupancy and well-being, each predicting different outcomes. The role overload hypothesis focuses on the premise that human energy is limited, and the more roles a person occupies, the more strain experienced and the greater the likelihood of negative effects on health and well-being (Goode, 1960). In contrast, the role enhancement model highlights the potential social and psychological benefits of occupying parent, partner and paid worker roles and proposes health enrichment as a result of simultaneous participation in these roles (Sieber, 1974). Interestingly, although experience and common sense strongly suggests that role overload is experienced by many employed parents, empirical research indicates that, on average, adults who occupy more roles experience better physical and psychological well-being than those who have fewer roles (Barnett & Hyde, 2001; Hibbard & Pope, 1991; Verbrugge, 1983; Waldron, Weiss, & Hughes, 1998).

While empirical support for the role enhancement hypothesis has been fairly consistent, the over-reliance on cross-sectional research designs has impeded understanding in the area, particularly the ability to adequately evaluate the contribution of alternative explanations (i.e., that healthy people are more likely to be employed, get married and have children) in observed social role–health status associations (Waldron et al., 1998). In addition, the argument has been made that given the heterogeneous nature of men's and women's lives, research inquiries which focus on whether a specific social role or combination of roles is good or bad for all men and women is not likely to produce useful insights (Doyal, 1995). To more adequately represent the varied life circumstances within which men and women enact their social roles, recent research has turned to questions about the importance of contextual factors in the relationship between social roles and health status (Ali & Avison, 1997; Voydanoff & Donnelly, 1999). Considerable evidence suggests that gender, income adequacy, and life stage are three important factors which shape many of the opportunities and constraints associated with work and family role configurations, and in turn, impact on health status (Denton & Walters (1991), Arber (1997); Denton & Walters, 1999). For example, despite women's increasing labour force presence, employed women still retain primary responsibility for the bulk of domestic work in two-parent households (Silver, 2000; Sullivan, 2000). The implication is that men and women occupying the same types of roles may experience them in profoundly different ways. Similarly, income adequacy is a marker of one's degree of access to health-enhancing social, material and behavioural resources (Lynch & Kaplan, 2000); it follows, therefore, that combining the roles of parent, paid worker, and partner, for example, may have very different health influences depending on one's economic circumstances. Finally, family and work role demands, responsibilities, and resources vary throughout the adult life course. Compared to older, established couples, role overload may be more common place among young adults attempting to balance the demands of young children and paid work responsibilities within the context of limited financial resources (Horwitz, McLaughlin, & White, 1997). Unfortunately, longitudinal studies have generally analysed data for either men or women, and/or have used restricted samples in terms of age and economic circumstances, thereby precluding comparisons by gender, income adequacy, and life stage.

Therefore, to elucidate the role of gender, income adequacy, and life stage in the social role–health status relationship, and to lessen the potential contribution of health selection into these roles, the present study analysed longitudinal data from a recent national survey of Canadian men and women. One major research question guided the present study: How is social role occupancy related to subsequent health status among employed Canadians and does the nature of this relationship vary by gender, income adequacy, and life stage?

Despite many societal changes over the last 30 years, the influence of gender still operates at many different levels in society. For example, research suggests that gender plays a role in shaping qualitative aspects of work and family roles (Matthews, Hertzman, Ostry, & Power, 1998; Roxburgh, 1996). With regard to the domestic environment, while men are more involved than previous generations in their family roles, women still retain primary responsibility for the majority of housework and childcare (Silver, 2000; Sullivan, 2000). In addition to the role that gender plays in the distribution of specific work and family related demands and resources, men and women may also develop different role identities along gender lines (Simon, 1992). Gender identity theory purports that the importance of work and family roles differs for women and men. That is, in keeping with traditional gender-specific socialization and expectations, paid work is more salient for men's well-being, and parent and partner roles is more salient for women's. Some support for this hypothesis exists in the research literature. For example, although occupancy of the employee role is, on average, associated with positive health status for both women and men, several studies have reported stronger health effects for men than women (Barnett, Brennan, Raudenbush, Pleck, & Marshall, 1995; Hibbard & Pope, 1993; Wickrama, Conger, Lorenz, & Mathews, 1995). In addition, parental status has not been found to be as predictive of men's as compared to women's psychological and physical health. On the other hand, a number of studies indicate that marriage/cohabitation is important to men's physical and mental health (Lund et al., 2002; Goldman, Korenman, & Weinstein, 1995; Joung et al., 1997), and may even be more strongly associated with health status than for women (Avlund, Damsgaard, & Holstein, 1998). Compared to the study of individual social roles, understanding of gender differences and similarities in the health effects of multiple role occupancy is more limited. This area of study has been traditionally viewed as a women's health issue; studies which have examined the relationship between men's work roles, family roles, and well-being are relatively few in number, largely restricted to middle/upper-middle income samples and/or employed cross-sectional study designs. The limited evidence that does exist, however, suggests that combining work and family roles may have a weaker or non-existent effect on health for men compared to women (Hibbard & Pope, 1991).

In addition to limited gender analysis, there has been a lack of attention paid to understanding the economic context in which women and men carry out their work, parent, and partner roles (Arber, 1991). Research has repeatedly demonstrated a relationship between socioeconomic status (SES) and health, with individuals lower in SES, compared with those above, generally experiencing higher rates of morbidity and mortality (Lynch & Kaplan, 2000; Sorlie, Backlund, & Keller, 1995). While the relationship between SES and well-being has been found for both genders, SES inequalities in health are generally less consistent for women than men (MacIntyre & Hunt, 1997).

Although a number of factors have been proposed to explain the link between indicators of SES and health outcomes (Lynch & Kaplan, 2000), SES may exert its effect on health status, in part, through work and family roles. For example, SES, like gender, is important in shaping the nature of paid work available to individuals; that is, compared with those higher in the SES hierarchy, the work conditions of lower SES individuals tend to be associated with a greater risk of ill health (House, Strecher, Metzner, & Robbins, 1986; Marmot et al., 1991; Matthews et al., 1998). Though subject to less empirical scrutiny than the paid work environment, some evidence suggests that SES may also impact on individuals’ exposure to a variety of domestic strains and demands as well (Marshall & Barnett, 1991; Conger et al., 1990).

In recent studies, researchers have examined health inequalities among women according to both their social roles and their economic circumstances. These studies have clearly highlighted the diversity in health status among women according to SES, and have identified single mothers as particularly at risk of poor health (Denton & Walters (1991), Arber (1997); Bartley, Popay, & Plewis, 1992; Macran, Clarke, & Joshi, 1996). Research indicates that SES may moderate the relationship between social role occupancy and health status; that is, the net health impact of a particular social role configuration may vary depending on the women's economic position (Khlat, Sermet, & Le Pape, 2000). Indeed, several studies have suggested that a positive association between multiple roles and health status is less likely to emerge for women in lower than higher income groupings. Arber (1991) and Arber, Gilbert, and Dale (1985) found full-time employment to be associated with higher levels of physical illness among married mothers occupying manual jobs, but not among those in professional/managerial occupations. Similarly, Elliott and Huppert (1991) identified the physically healthiest middle-class women as those with full-time paid jobs and no dependent children, whereas among women from lower class families, full-time homemakers with young children were the healthiest group. Contrary to these findings, however, some studies have reported a greater risk of ill health among middle/higher income women working full-time (Bartley et al., 1992; Moser, Pugh, & Goldplatt, 1988; Walters & Denton, 1997; Walters, Lenton, & Mckeary, 1995) leading some researchers to speculate that the combination of paid and unpaid work stresses encountered by working women may lessen the positive health influences of higher SES standing. To complicate matters further, other studies have failed to find any moderating influence of SES on the relationship between work and family role occupancy and health status (Gijsbers van Wijk, Kolk, van den Bosch, & van den Hoogen, 1995; Martikainen, 1995; Weatherall, Joshi, & Macran, 1994).

Although analysis of SES inequalities in health has been a common research topic in the study of men's health, the potentially added explanatory significance of partner and parental roles has rarely been considered. The limited research available on this issue, however, indicates a weaker or non-existent effect of family roles on health for men compared with women, after accounting for the contribution of SES factors (Denton & Walters (1991), Arber (1997); Arber & Lahelma, 1993; Matthews, Manor, & Power, 1999). Unfortunately, few studies (and in particular longitudinal studies) have systematically compared women and men regarding the nature of the relationship between partner, parental, and work role occupancies, SES and physical health outcomes.

Stage of life may also moderate the relationship between social role occupancy and health status. Family and work role demands, responsibilities, and resources vary considerably throughout the adult life course (Moen & Yu, 2000). A recent Canadian survey found that the amount of time stress reported by employed parents generally lessened with increasing age (Statistics Canada, 1999). This finding is not surprising given that young parents tend to have younger children, be less established in their careers, and have fewer financial resources (Statistics Canada, 2000). Thus, balancing work and family demands may be more health damaging than health enhancing for younger, compared to older employed parents. On the other hand, research suggests that the effects of various risk factors on health status is much stronger for older than younger adults as a result of longer periods of exposure and greater biological susceptibility (House, Kessler, & Herzog, 1990). For example, socioeconomic differences in health status are generally quite small or non-existent in young adulthood, increasing in middle and advanced age. Finally, life stage may also be a marker for cohort-specific beliefs and attitudes. Some research indicates that younger Canadians are more likely than their older counterparts to hold views supportive of less traditional roles for men and women (Zukewich Ghalam, 1997). Compared to older age groups, many young parents today likely grew up in households in which both parents were employed (Statistics Canada, 2000). Thus, predictions based on gender identity theory may be less applicable to younger than older Canadians. Unfortunately, much of the social role research has tended to focus on middle-aged adults (and women in particular) so little information is available concerning the health effects of roles and role combinations for younger men and women of differing economic circumstances (Waldron et al., 1998).

Section snippets

Hypotheses

The present study examines whether specific family and work role configurations of Canadian adults in 1994/95 are related to their physical health in 1996/97, and whether the nature of these relationships differ by gender, income adequacy, and life stage. Two specific hypotheses were tested:

  • 1.

    Compared to single and double role configurations, triple role occupancy will be associated with subsequently better health status.

  • 2.

    The positive association between triple role occupancy and subsequent health

Survey design

The present study involved analysis of Statistics Canada's National Population Health Survey (NPHS) data. This is a household survey designed to measure the health status of Canadians and to increase understanding of a broad array of health influences (Tambay & Catlin, 1995). The survey has been described in detail previously (Swain, Catlin, & Beaudet, 1999). Briefly, the NPHS began in 1994/95 and will collect information about the health of the Canadian population every 2 years over a 20 year

Baseline characteristics of the sample

With the exception of life stage, men and women differed significantly in several respects. A greater proportion of men were single or married and a greater proportion of women were divorced/separated/widowed. Although a higher percentage of men than women reported belonging to the lowest educational attainment category (less than high school), they were also more likely to report higher levels of income adequacy. With regard to social role occupancy, a higher percentage of men than women were

Discussion

Social role researchers are increasingly going beyond simply asking whether role occupancy is associated with health status to clarifying the context in which particular social role–health relationships emerge (Ali & Avison, 1997; Voydanoff & Donnelly, 1999). Consistent with this perspective, the purpose of the present study was to clarify the relationship between social role occupancy and health status over time with a sample of employed Canadian men and women who differed with respect to

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