Women health-care providers with children at home experience especially heavy distress and are at high risk for such mental health problems as psychological distress and poor marital- and job-role quality and for such stress-related physical health problems as tension headaches. TMJ, hypertension, coronary artery disease (CAD), peptic ulcer disease (PUD) and nonulcer dyspepsia, and fibromyalgia. Alternative career options (e.g., part-time) have been proposed as a means of decreasing distress by increasing flexibility. Whereas such options have already been adopted in such less prestigious health-care occupations as licensed practical nursing, demand for female physicians is prompting the creation of flexible career options in medicine.
The aim of the proposed three-year in-depth interview and survey study is to estimate the relationship between full- and part-time work schedules and stress-related mental and physical health outcomes in a random sample of 200 married women ages 25-50 with under-high-school-age children in two-health-care professions that vary in occupational prestige, medicine and licensed practical nursing, and who vary in race/ethnicity. The focus of our proposed study is on one key aspect of flexibility, work scheduling, conceptualized as a complex construct comprising at least two components-- number of work hours (i.e., full-time vs. reduced hours) and work arrangements (e.g., compressed work weeks, weekend or night work, standard work week). We hypothesize that the relationship between work hours and health outcomes varies with work arrangements. We also assess several subjective aspects of work scheduling, including fit, or how well the schedule meets the needs of the health-care professional and her children, spouse, and elderly dependents (if any), and, among reduced-hours workers, the discomfort she experiences over the tradeoff of certain professional activities for more non-work time. These subjective indicators are also thought to mediate or moderate the relationship between work hours and health outcomes. The proposed project addresses four major questions: 1) Are full- time married women with children employed in medicine and licensed practical nursing at higher risk for stress-related mental- and physical-health problems than their reduced-hour counterparts? 2) Do these relationships depend on work arrangements, occupational prestige, race-ethnicity, age, household income, medical setting, number of children at home, elderly dependent care, and, for doctors, area of medical specialization?; 3) Are objective job conditions (e.g., work hours or arrangements) or subjective indicators (e.g., fit, discomfort over tradeoffs) better predictors of stress-related health outcomes; and 4) What are the processes by which schedules affect health outcomes? For example, does the degree to which the health-care professionals are optimizing their work- family preferences (i.e., fit) mediate this relationship?
| Barnett, R C; Hyde, J S (2001) Women, men, work, and family. An expansionist theory. Am Psychol 56:781-96 |
