Covid-19 impacts on unemployment on the migration-gender intersections in Spain, a multilevel study

Abstract Background The covid-19 pandemic has led to several socioeconomic consequences, which ultimately affect individuals’ health status. This study aims to assess and explore the short-term impacts of the pandemic on the labour market in Spain, through the intersectional and multilevel analysis of unemployment rates. Methods Cross-sectional study using data from the Spanish Labour Force Survey from the three quarters before and after the outbreak of covid-19 (N = 922,074). Multilevel logistic regressions were used to calculate the odds of being unemployed for the intersectional positions on gender and migration background, nested within 7 educational levels. Results Before (pre) and after (post) the covid-19 outbreak, women had higher odds (ORnw-pre=1.974; p-value<0.001; ORmw-pre=2.202; p-value<0.001) of being unemployed than men (ORmm-pre= 0.887; p-value<0.001). However, the pandemic affected women's employment unequally. Migrant women experienced an increase in the risk of being unemployed 6 times larger than native women (48.67% (ORmw-post=2.688; p-value<0.001) v 8.78% (ORnw-post=2.062; p-value<0.001)). Moreover, in the post-covid 19 scenario, individual characteristics of migrant women (ORmw-post=2.688; p-value<0.001) played a larger role in the risk of being unemployed than their educational level (MOR=2.537). Conclusions Migrant women are disproportionately bearing the short-term economic consequences of the pandemic by means of higher unemployment rates, underpinning experiences of racism and gender discrimination. Increasingly attention needs to be placed on discriminated groups in society. Targeted protective policies that foster labour market integration and increase social protection are needed to mitigate and decrease existing economic, social, and health inequalities. Key messages • Migrant women have disproportionately carried the economic impact of the covid-19 pandemic in Spain. Targeted protective policies are needed to mitigate existing socioeconomic and health inequalities. • Migrant women’s gender and migration background play a greater role than their education in the risk of being unemployed, underpinning experiences of racism and gender discrimination.


Background:
Dyadic processes of workers and significant others like partners, family members and friends can play an important role in adaptation to chronic disease, thereby influencing health and work outcomes. This study aimed to increase our understanding of dyadic processes in sick leave duration of workers with chronic diseases. We examined illness perceptions, return to work expectations (RTWE) and perceptions about significant other responses (i.e., engagement, buffering and overprotection) of workers and their significant others in relation to sick leave duration.

Methods:
This study used survey and registry data of 90 dyads of sicklisted workers with a chronic disease and their significant others. Simple and multiple regressions in which perceptions of workers and significant others were included simultaneously were used to examine associations with sick leave duration. Results: Workers' and significant others' perceptions were moderately to strongly correlated (r ranged from .46 to .80). Sick leave duration was associated with illness perceptions of both workers (b = 8.58, p = .001) and significant others (b = 6.46, p = .008), with more negative illness perceptions associated with a longer sickness absence. In the multiple regression, illness perceptions explained 12.3% of the variation in sick leave duration. Sick leave duration was also associated with RTWE of workers (b = -76.87, p<.001) and their significant others (b = -92.47, p<.001), with more positive RTWE associated with a shorter sickness absence. The RTWE of dyad members accounted for 24.5% of the variance of sick leave duration.

Conclusions:
Illness perceptions and RTWE of workers and their significant others are strongly interdependent and associated with sick leave duration of workers with chronic diseases. A dyadic approach targeted at improving illness perceptions and RTWE of both workers and significant others might be more effective than an individualistic approach in preventing long-term sickness absence. Key messages: Return to work expectations and illness perceptions of workers and their significant others are associated with the duration of sickness absence of workers with chronic diseases. A dyadic approach targeted at both workers and their significant others might be more effective than an individualistic approach in the prevention of long-term sickness absence.

Background:
The covid-19 pandemic has led to several socioeconomic consequences, which ultimately affect individuals' health status. This study aims to assess and explore the short-term impacts of the pandemic on the labour market in Spain, through the intersectional and multilevel analysis of unemployment rates.

Methods:
Cross-sectional study using data from the Spanish Labour Force Survey from the three quarters before and after the outbreak of covid-19 (N = 922,074). Multilevel logistic regressions were used to calculate the odds of being unemployed for the intersectional positions on gender and migration background, nested within 7 educational levels.

Conclusions:
Migrant women are disproportionately bearing the short-term economic consequences of the pandemic by means of higher unemployment rates, underpinning experiences of racism and gender discrimination. Increasingly attention needs to be placed on discriminated groups in society. Targeted protective policies that foster labour market integration and increase social protection are needed to mitigate and decrease existing economic, social, and health inequalities. Key messages: Migrant women have disproportionately carried the economic impact of the covid-19 pandemic in Spain. Targeted protective policies are needed to mitigate existing socioeconomic and health inequalities. Migrant women's gender and migration background play a greater role than their education in the risk of being unemployed, underpinning experiences of racism and gender discrimination.

Background:
The financial burden long-term sick leave places on society are immense and amounted to an annual cost of 180 billion NOK in Norway. Epidemiological and sociodemographic risk factors related to sickness absence and return to work (RTW) are well studied, less is known regarding self-perceived biopsychosocial barriers for RTW. The aim of this study was to investigate the diversity of barriers for RTW as experienced by long term sick listed employees.

Methods:
The study is a large-scale qualitative interview study (n = 85), using semi-structured telephone interviews. Participants were eligible to participate if they had received sick leave benefits >6 months and <1,5 years at the time of recruitment, for at least 50% of their employed work hours. The data was analysed with a directed qualitative content analysis combined with a summative approach. A deductive approach, guided by the theoretical framework provided in Model of Human Occupation (MoHO) were used in the analysis process. In MoHO, the main categories are person specific components and environmental components.

Results:
The study generated 952 coded meaning units describing barriers for RTW. Of these, we were able to deductively code 917 within the framework of MoHO. In the person specific concept, performance capacity barriers were dominant (n = 530). Volitional barriers (n = 164) were related to personal causation, hereunder self-efficacy (n = 24), and one's sense of capacity (n = 91). Barriers related to habituation (n = 64) was expressed as habits, both necessary habits and undesirable habits. Barriers related to the environmental component amounted to 388. The majority was linked to occupational environment (n = 217), including availability of adequate work tasks and barriers related to the healthcare system.

Conclusions:
The experienced RTW-barriers extended beyond health-related barriers, for most of the participants the barriers were related to both person specific components and environmental components.

Key messages:
By gaining a greater understanding of the experienced RTWbarriers we could possibly provide more tailored RTWservices and help sick listed to a safe and sustainable return to work. The experienced RTW barriers for long term sick listed were primarily related to person specific and environmental components, and thus extended beyond health-related barriers.

5.K. Workshop: National and European studies on health literacy in children and adolescents
Abstract citation ID: ckac129.317 Health literacy describes how people use health information to make informed decisions in context of healthcare, disease prevention and health promotion. Enhancing health literacy of populations is critical and in particular important at an early age, which is understood to be more sustainable because health literacy contributes to improved personal health and development. Low health literacy in child and adolescent populations has been linked to worse health outcomes and health disparities in Europe, making health literacy of children and adolescents an important public health topic. Developing and delivering target group specific interventions and services requires precise data generation on the state of health literacy in early age. In the past decade, several conceptual approaches have been undertaken but methodological sound, validated and reliable measurement tools are still scarce. Available systematic reviews show that most tools originated from North America and/or English speaking countries. However, in the past years European researchers have been involved with research on health literacy in childhood and adolescence, the result of which culminated into heavy progress regarding the development of health literacy measurement instruments, including generic health literacy, digital health and mental health literacy. These new developments lead to the availability of validated tools for school-aged children, including primary and secondary school children. The purpose of this workshop is to bring together five contemporary health literacy studies conducted in child and adolescent populations across Europe, including national and European-wide studies. Both methodological findings regarding the measurement tool and 15th European Public Health Conference 2022