Gender differences

Women with low job control may be at greater risk for diabetes.

Women in demanding jobs may be more likely to suffer a heart attack.

Women who work the night shift show increased odds of being diagnosed with breast cancer and metabolic syndrome.

These alarming findings are from studies published in recent years. Although more research is needed to determine the pathways that may link certain work environments and schedules to adverse health outcomes, experts say reducing stress and boosting autonomy might be part of the solution.

Kerstin Aumann, senior research associate at the New York-based Families and Work Institute, cited stress as an important factor for women workers. A 2008 FWI study (co-authored by Aumann) found that women workers were more likely than men to report high levels of stress.

“Women also are more likely to report more frequent sleep problems than men, and both stress and sleep are related to a host of outcomes that are of interest to the employer and relevant to the worker’s well-being,” Aumann said.

That may be especially true of shift work. A 2009 article from the University of Toronto identified several consequences of shift work for women, including poor sleep quality, reproductive problems, and higher risk of breast cancer and cardiovascular disorders. Additionally, insufficient rest is associated with more aggressive breast cancer tumors, according to research from Case Western Reserve University in Cleveland.

Cardiovascular disease is another concern. A 2011 study from Kingston, Ontario-based Queen’s University found a higher prevalence of metabolic syndrome among women with a history of performing shift work. Metabolic syndrome is a cluster of factors – high blood pressure, low levels of high-density lipoprotein (“good”) cholesterol, high triglycerides, elevated blood glucose and large waist circumference – associated with an increased risk of heart disease.

Study author Joan Tranmer, professor in the School of Nursing at Queen’s University, is conducting another study to understand why shift work may have an unhealthy effect on women. Is it due to stress, poor diet or lack of sleep – or perhaps because shift work disrupts their biochemical rhythms?

“I don’t think we’re poised yet to propose interventions because we don’t understand what it is about shift work that puts women potentially at increased risk – because some women can cope with it just fine,” Tranmer said.

Regarding the focus on women, she explained that previous research on shift work predominately involved men. Women typically have cardiovascular events later in life than men, so research may not have found a relationship between shift work and heart attacks because women were not studied long enough, she said.

“We know there are gender differences in the way that men and women cope with work stress and work patterns,” Tranmer added. “Available research would suggest that the demands of work and the demands of home and life are perceived to be greater for women than they are for men.”

Multiple studies indicate job control impacts women’s health. Researchers from Harvard University and Brigham and Women’s Hospital conducted a 10-year study of more than 22,000 women. Results showed women in high-strain jobs (high demand, low control) and active jobs (high demand, high control) were 38 percent more likely to have a cardiovascular event than women in low-demand, high-control jobs.

A nine-year study from the Institute for Work & Health and the Institute for Clinical Evaluative Sciences focused specifically on job control, which refers to a person’s power to make decisions about how they perform their job and use their skills. Researchers found a link between low job control and diabetes in women but not men, leading them to conclude that job control could be an important risk factor to address.

That lines up with Aumann’s view. She said learning and being challenged tend to be more strongly related to job satisfaction for women than men, and women may benefit from more autonomy at work. Employers can do this by ensuring the worker is a good fit for the position and then giving her the leeway to decide the best way to use her skills to complete the job. Other suggestions from Aumann include seeking input from workers on solving problems and giving them control over their schedule through flexible start and stop times or choice of when to take a break.

“Another important aspect is giving an employee a sense that they can be [themselves] at work, that they don’t have to hide their personality or certain aspects of who they are,” Aumann said.

Autonomy and job learning and challenge are two of six criteria for an effective workplace identified by FWI; the others are work-life fit, supervisor task support, climate of respect and trust, and economic security. Aumann also emphasized the importance of reducing stress levels by making sure the work that employees are expected to complete is reasonable within the given time frame.

Another factor is societal expectations for men and women. The “ideal worker” has traditionally been defined as a full-time male employee who puts in long hours and elevates work over family. Those expectations unfairly burden men as well as women, but especially women because data indicates they take on the majority of house work, Aumann said.

She called for updating ideas about work and family to reflect modern conditions. Tranmer agreed. However, she objects to striving for “work-life balance,” as in giving equal time to both.

“I just think we need to be able to integrate or manage both our work demands and our life demands better,” Tranmer said.