444 Chapter 12Effects on Health. A cross-cultural study
of 25 European countries showed that women’s
lower well-being compared to that of men
was due in part to the fact that women en-
gaged in less paid work and more domestic
work compared to men (Boye, 2009). The
more hours worked outside the home was as-
sociated with higher well-being for women,
and the more hours of domestic work was
associated with lower well-being for women.
When women who work outside the
home are compared to women who work
inside the home, a wealth of evidence indi-
cates that employed women report better
psychological and physical health (Fokkema,
2002; Khlat, Sermet, & Le Pape, 2000), even
in traditional societies like Spain (Artazcoz,
Borrell et al., 2004). Even among women with
children, the weight of the evidence is that
employed mothers are healthier than nonem-
ployed mothers, and more so if children are
older (Fokkema, 2002).
One problem with studies that compare
the health of employed women to housewives
is that they are often cross-sectional, meaning
the people are studied at a single point in time.
Thus we do not know if employment leads
to an improvement in health or if healthier
people are more likely to be employed. This is
thebasisoftheselection effect. Longitudinal
studies in which both employment and health
are tracked over time enable us to determine
whether health leads to employment or em-
ployment leads to health. There is evidence
for both. Physically healthier people are more
likely to be employed (Christ et al., 2007), and
employment leads to better health for women
(Klumb & Lampert, 2004).Explanations. The employee role bene-
fits women’s health for a number of reasons.
Employment increases self-esteem, instills a
sense of accomplishment, and provides moreon health. When we compare women who
do and do not work outside the home, we are
comparing employed women to two groups of
nonemployed women—unemployed women
and women who choose not to work outside
the home. The two groups are not the same.
The effect of employment on health is a
topic that necessarily focuses on women be-
cause there is more variability in women’s
than men’s employment. In this first section of
the chapter, I focus on the effects of women’s
employment on their health. Then, I examine
the effects of multiple roles on women’s and
men’s health and how work and family roles
influence one another. I also evaluate the effect
of work on health by briefly describing the lit-
erature on retirement. After evaluating the ef-
fects of the mere possession of the paid worker
role on health, I turn to the implications of the
more qualitative aspects of the paid worker
role for health.Women’s Employment
A historical explanation of why women were
more distressed and had worse health than
men was that women were less likely to pos-
sess the paid worker role (Gove & Tudor,
1973). Work was associated with a number
of resources, not the least of which was eco-
nomic, and women had less access to this
resource than men. However, when women
entered the paid workforce, people began
to consider the negative effects of employ-
ment on health. People were concerned that
women who combined work and family
roles would suffer role strain and role over-
load. People were also concerned that women
working outside the home would detract
from the time women spent taking care of
their husbands and family. Thus, in this sec-
tion, I examine the implications of women
working for their own health and the implica-
tions of women working for the family.M12_HELG0185_04_SE_C12.indd 444 6/21/11 9:16 AM