Elsevier

Public Health

Volume 120, Issue 10, October 2006, Pages 966-975
Public Health

ORIGINAL RESEARCH
The impact of multiple role occupancy on health-related behaviours in Japan: Differences by gender and age

https://doi.org/10.1016/j.puhe.2006.06.006Get rights and content

Summary

Objectives

We examined gender and age differences in the impact of multiple role occupancy on health-related behaviours and health status among working age Japanese adults.

Methods

We analysed the individually linked, nationally representative data of 5693 respondents aged 20–59, who completed the Comprehensive Survey of the Living Conditions of People on Health and Welfare and the National Nutrition Survey, conducted by the Japanese government in 1995.

Results

Younger women benefited from multiple roles (less smoking), while younger men demonstrated more high-risk behaviours (more smoking, heavier drinking). By contrast, middle-aged men benefited from multiple roles (less smoking, fewer health problems), while middle-aged women reported lower health maintenance behaviours (less exercise, fewer health check-ups).

Conclusions

Japanese society appears to be undergoing a transition in gender roles, as reflected by age and gender differences in the impact of multiple roles on health and health-related behaviours. Middle-aged males benefit from multiple roles (being the primary bread-winner and being married), while middle-aged women do not. This pattern seems to break down for younger Japanese men and women.

Introduction

The rise of dual earner couples in Western, industrialized countries spurred an intense debate concerning the impact of multiple roles on the mental and physical health of women and men. According to the ‘scarcity hypothesis’, the more roles a woman accumulates, the more conflict and strain she will experience, and the greater her chances of experiencing psychological distress and ill health.1 According to the competing ‘expansion hypothesis’, the costs of added roles are more than offset by the rewards that they bring, such as prestige, self-esteem, social support, financial remuneration, and greater control and power within the family.2, 3

Accumulated evidence has laid to rest earlier concerns that women's rising participation in the labour market threatens their well-being.4 Multiple roles have been linked to positive mental and physical health among both genders.5, 6 At the same time, multiple roles can be detrimental for some women under some circumstances, and additionally the effects of the same role combinations may be different for men and for women.7, 8

Japanese society has lagged behind Western countries in terms of changing gender roles. Despite having the most long-lived women in the world, Japan ranks 38th in the world on the United Nations Development Program's gender empowerment index.9 Japanese society has steadfastly maintained a strict division of labour between both genders, so that men have been viewed as the primary bread-winner, whilst women's roles have been focused primarily on the home and family.10

In recent years, however, even the traditional family arrangements have begun to break down in Japan. The decades-long recession—coupled with unprecedented high levels of male unemployment, as well as the erosion of job security and the lifetime employment system—have steadily undermined the traditional gender norms in that society. The traditional role of the husband as a reliable economic provider has been severely shaken and has possibly reduced men's bargaining power within marital relationships. At the same time, women have become much less tolerant of traditional gender roles.10, 11

Another notable societal trend relevant to the changing gender roles in Japan is the rapid aging of the population. Population aging has increased the demand for long-term care, which in traditional Japanese society falls upon the shoulders of women (or more precisely, the daughters-in-law of aging parents). The revolt of Japanese women against traditional expectations of care-giving has itself been partly blamed for the declining marriage and fertility rates in that country.12

Against this background of changing social realities, few studies in Japan have examined the impact of multiple roles on health. Accordingly, in the present study we sought to examine the differential impacts of multiple role occupancy on health-related behaviours among young and old men and women. Using recent nationally representative surveys, we set out to test the following hypotheses:

  • 1.

    Multiple role occupancy is associated with increased risks of stress-related coping behaviours, specifically smoking and alcohol consumption, and also with lower prevalence of health-promoting and maintenance behaviours, such as regular exercise and health check-ups.

  • 2.

    There is an interaction between multiple role occupancy and age group. Specifically, we expect a more pronounced adverse impact of multiple role occupancy on health-related behaviours among younger adults compared to middle-aged adults, due to a combination of: (a) marital conflicts within younger Japanese couples stemming from women's rising expectations of shared household responsibilities; and (b) recent threats to the traditional role of men as primary bread-winners, accompanied by their gradual loss of authority and bargaining power within households.

  • 3.

    The association between multiple role occupancy and health-related behaviours is partly mediated by worries among women and men over economic security and future care-giving demands.

Section snippets

Sample

The Comprehensive Survey of the Living Conditions of People on Health and Welfare (CSLCPHW) and the National Nutrition Survey (NNS) have been carried out nationwide among randomly sampled districts in Japan by the government every three years and annually, respectively.13, 14 Both surveys include sections on health and socio-economic status (SES) and trained interviewers visited the respondents’ homes. The study population was the respondents of each survey in 1995. CSLCPHW was administered

Sample distribution (Table 1)

After exclusion of households that did not provide complete information on relationships among family members, our final data set comprised 3011 females and 2682 males, aged 20–59. Women reporting ‘no social role’ consisted mainly of single young women in their 20 s, as well as students and other unpaid workers (excluding housewives). The corresponding category among men similarly consisted of single young men in their 20 s and students.

Number of social roles and health-related outcomes in women (Table 2)

Among women overall, the risk of smoking declined as their

Discussion

Studies of multiple role occupancy in Western countries have failed to confirm earlier fears that women's increasing participation in the paid labour force would lead to role overload and increase their burden of mental and physical morbidity.4 Considerable evidence has supported the validity of the role expansion hypothesis, which suggests that the benefits of added roles for women have outweighed the costs.2, 3 Fewer studies have been carried out among men, or directly compared men to women.

Acknowledgements

This study was supported by Grant No. H11-toukei-002 (Principal investigator of the national research group: Prof. Hiroshi Yanagawa, President of Saitama Prefectural University) from the Ministry of Health, Labour and Welfare, Japan.

Statement of competing interest: There are no competing interests on this paper.

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