Is strain due to household and family work associated with a subjective need for rehabilitation among employees? A cross-sectional study

Abstract

Background: The gender-specific unequal distribution of paid employment and unpaid household and family work may entail specific implications for women's and men's health and work ability. Medical rehabilitation is provided to maintain or restore work ability and to prevent disability pensioning. However, more than half of the employees who receive disability pension have not utilized any pre-retirement rehabilitation services. The study was conducted to examine associations between strain due to unpaid work and the subjective need for rehabilitation among employees with an increased risk of early retirement due to adverse health conditions.

Methods: Cross-sectional data from the "Third German Sociomedical Panel of Employees" (GSPE-III) were analysed. The sample comprises 1,908 German employees aged between 42 and 56 years. Logistic regression analyses were conducted separately for women and men to explore the association between the strain level and the subjective need for rehabilitation.

Results: Overall, women reported a higher strain level compared to men. Strain due to housework was not associated with the subjective need for rehabilitation in men and women. However, after adjustment for socio-demographic, work- and health-related characteristics the odds for a subjective need for rehabilitation were three times higher for women (OR=2.9, p <0.001) and two times higher for men (OR=2.0, p=0.027) with a high level of strain due to family work compared to persons with a low strain level.

Discussion: This study analysed the strain of unpaid work in the context of the utilization of medical rehabilitation services. Although women report a gender-specific higher strain due to unpaid work, a high strain level due to family work seems to be an additional and independent factor influencing the subjective need for rehabilitation for both genders equally.

Conclusion: To prevent disability pensioning, more consideration should be given to the strain factors associated with unpaid family work when designing and organising interventions to promote access to medical rehabilitation services.

Keywords: Arbeitslast; Employment; Erwerbstätigkeit; Gender role; Geschlechterrolle; Health care utilization; Inanspruchnahme von Gesundheitsleistungen; Rehabilitation; Workload.