Educational inequalities in self-rated health and emotional exhaustion among workers during the COVID-19 pandemic: a longitudinal study.

OBJECTIVE: This study aimed to investigate trends in educational inequalities in poor health and emotional exhaustion during the pandemic among workers, and differences in trends between men and women. METHODS: Five waves (2019-2021) from the longitudinal study 'the Netherlands Working Conditions Survey COVID-19 study' were used (response rates: 32-38%). Generalized logistic mixed models were used to estimate the changes in absolute and relative educational inequalities in poor health and emotional exhaustion for all workers (n = 12,479) and for men and women, separately. RESULTS: Low and intermediate educated workers reported more often poor health (OR 2.54; 95% CI 1.71-3.77 and OR 2.09; 95% CI 1.68-2.61, respectively) than high educated workers. Intermediate educated women (OR 0.49; 95% CI 0.37-0.64) reported less emotional exhaustion than high educated women, but no differences were observed among men. The prevalence of poor health first decreased across all educational levels until March 2021, and bounced back in November 2021. A similar pattern was found for emotional exhaustion, but for low and intermediate educated workers only. Relative educational inequalities in poor health reduced among men during the pandemic, and absolute differences decreased among men and women by 2.4-2.6%. Relative educational inequalities in emotional exhaustion widened among men only. Absolute differences in emotional exhaustion first increased among both men and women, but narrowed between the last two waves. DISCUSSION: Socioeconomic inequalities for poor self-rated health remained but narrowed in relative and absolute terms during the pandemic. With regard to emotional exhaustion, socioeconomic inequalities returned to pre-COVID-19 levels at the end of 2021.

Prevention program at construction worksites aimed at improving health and work ability is cost-saving to the employer: results from an RCT.

BACKGROUND: To prolong sustainable healthy working lives of construction workers, a prevention program was developed which aimed to improve the health and work ability of construction workers. The objective of this study was to analyze the cost-effectiveness and financial return from the employers' perspective of this program. METHODS: A total of 293 workers in 15 departments were randomized to the intervention (n = 8 departments) or control group (n = 7). Data on work ability and health were collected using questionnaires. Sick leave data were obtained from the companies. Both the cost-effectiveness analyses and return on investment analyses were performed. RESULTS: After 12 months, the absenteeism costs were significantly lower in the intervention group than in the control group. At 12-month follow-up, no significant differences were found with respect to the primary outcomes (work ability, mental and physical health status) and secondary outcomes (musculoskeletal symptoms), meaning that the intervention was not cost-effective in comparison with the control group. The net-benefit was €641 per worker, and the intervention generated a positive financial return to the employer. CONCLUSION: The intervention in the present study was cost-saving to the employer due to reduced sickness absenteeism costs in the intervention group compared with the control group. However, the intervention cannot be regarded as cost-effective as no significant effects were found for work ability and health.