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Gender and Educational Level Modify the Relationship Between Workplace Minsang YOO, et al.: Workplace mistreatment and health problems 427 J Occup Health 2015; 57: 427–437 Journal of Occupational Health Gender and educational level modify the relationship between workplace mistreatment and health problems: a comparison between South Korea and EU countries Minsang Yoo1, Saerom Lee2 and Mo-Yeol Kang1,2 1Department of Preventive Medicine, College of Medicine, Seoul National University, Republic of Korea and 2Occupational Safety and Health Research Institute, Republic of Korea Abstract: Gender and educational level modify the place did not significantly affect EU workers. Conclu- relationship between workplace mistreatment and sions: Workplace mistreatment is significantly associ- health problems: a comparison between South ated with physical and mental health problems, espe- Korea and EU countries: Minsang YOO, et al. Depart- cially among workers with higher educational levels and ment of Preventive Medicine, College of Medicine, females who work alone in Korea. Seoul National University, Republic of Korea— (J Occup Health 2015; 57: 427–437) Objectives: This study investigated effects of workers’ cultural and personal characteristics on the relationship Key words: Cross-cultural, Educational levels, Gender between workplace mistreatment and health problems difference, Job stress, Workplace mistreatment in both South Korea and EU Countries. Methods: Data were obtained from nationally representative interview Over the past two decades, workplace mistreat- surveys: the third Korean Working Conditions Survey ment has been recognized as a serious problem within (KWCS) in 2011 (50,032 participants) and fifth European the working environment, and this relatively new Working Conditions Survey (EWCS) in 2010 (41,302 research topic has now been studied extensively in participants). The Pressure-State-Response model was several European countries1−4). Even so, there is still adapted to explore differences in the relationship limited information about workplace mistreatment in between mistreatment and health problems according to country, and logistic regression analysis was used Asia, although in recent years, Asian researchers have after stratification of moderating factors. Workplace increasingly focused on workplace mistreatment as an 5, 6) mistreatment, such as discrimination, violence, harass- important social stressor in work contexts . ment, and self-reported health problems, were assessed The scope and terminology of workplace mistreat- by gender and educational level. Results: Among ment varies across the discipline, incorporating KWCS participants, there were 4,321 victims (14.70%) workplace discrimination, violence, and bullying. of workplace mistreatment; among EWCS participants, Workplace discrimination refers to actions of insti- there were 5,927 victims (17.89%). There was a signif- tutions and/or individuals within them that lead to icant positive association between workplace mistreat- unfair terms and conditions that systematically impair ment and self-reported health problems. A stronger the ability of group members to work7). Violence can association was found among workers with higher be defined as any form of aggressive behavior aimed educational levels in Korea (2- to 4-fold higher odds for mental and physical health problems), but there was no toward the goal of harming another human being, and significant difference by education level in workers of it can be both psychological and physical in nature. EU Countries. Female Koreans who worked alone had In the extreme form, violence may involve the use of a higher risk of health problems related to workplace physical force to harm or damage persons or prop- mistreatment than other gender compositions in the erty or to interfere with personal rights or freedom2). workplace (the OR for psychological symptoms reached Another form of aggressive behavior at work is bully- 6.631). In contrast, the gender composition of the work- ing. Workplace bullying includes both physical and nonphysical actions that offend or socially exclude a Received Nov 29, 2014; Accepted May 20, 2015 worker or group of workers; some researchers specify Published online in J-STAGE Jun 25, 2015 that this definition must include an intent to harm Correspondence to: M.-Y., Kang, Occupational Safety and Health either the individual or the organization8). For the Research Institute 400, Jongga-ro, Jung-gu, Ulsan, South Korea, purpose of this paper, we defined workplace mistreat- [681-230] (e-mail: [email protected]) ment to include workplace-related discrimination, 428 J Occup Health, Vol. 57, 2015 violence, abuse, or harassment. stronger or weaker effects on health among workers Cultural differences in construing the meaning of with different cultural and personal backgrounds. specific behaviors make it harder to determine which Given the negative personal and organizational behaviors are abusive9). Less attention has been paid effects of workplace mistreatment, every effort should to national differences in mistreatment, though some be made to understand the mistreatment process and researchers have pointed out the problems of using to prevent the consequent health outcomes. The aim questionnaires about bullying developed in other of this study was to investigate whether workers’ national contexts and approached workplace bullying cultural and personal characteristics affect the relation- cross-culturally6, 9). This context is important because ship between workplace mistreatment and health prob- the prevalence of workplace mistreatment varies lems. Gender and educational level were examined in according to workers’ perceptions10) and their national both Korea and EU countries in order to understand culture4). the health effects of workplace mistreatment and iden- Differences also exist in terms of the source of tify groups at risk. personal characteristics, such as gender and educa- tional level. It is important to identify risk groups Subjects and Methods of workplace mistreatment in the context of future We used data from the third Korean Working prevention. However, the results from empirical stud- Condition Survey (KWCS) in 2011 and fifth European ies on sociodemographic factors and mistreatment are Working Condition Survey (EWCS) in 2010. These inconsistent. For example, among personal charac- were nationally representative interview surveys and teristics, gender has been the most widely studied. included questions relating to workers’ socioeconomic Some studies have reported more significant effects of data, workplace environment, and social and occupa- mistreatment for women11, 12), while Hoel and Cooper tional health. Informed consent was obtained from found no significant gender differences in their all participants in both surveys, and detailed informa- UK-wide survey of bullying13). tion about these surveys is available at the following There has been substantial research on the health websites: http://www.eurofound.europa.eu/working/ outcomes of workplace mistreatment. For example, surveys/ for the EWCS and http://www.kosha.or.kr/ several cross-sectional studies have found evidence jsp/kwcs/ for the KWCS. The fifth EWCS comprises of correlations between exposure to mistreatment and data from 35 European countries with 43,816 partici- psychological, psychosomatic, and physical symp- pants. The third KWCS, which was based on the toms7, 14). Common symptoms reported by victims in EWCS, was conducted by the Korea Occupational different European countries include musculoskeletal Safety and Health Agency (KOSHA) in 2011. This complaints, anxiety, irritability, and depression15−18). survey recruited 50,032 participants by using strati- Two recent Norwegian longitudinal studies found fied, multistage, random sampling of household units. that exposure to bullying behavior in the workplace For our analysis, we excluded self-employed partici- predicts psychological distress two years later19, 20). In pants (N=8,629 in the EWCS; 20,321 in the KWCS), addition, social isolation, social maladjustment, low those aged under 20 (N=722 in the EWCS; 317 in self-esteem, sleep problems, concentration difficul- the KWCS), and participants who had missing data ties, chronic fatigue, and burnout seem to be common for some variables (N=1,329 in the EWCS); the final symptoms in victims of workplace mistreatment3). study sample included 33,136 participants for the The international cost of outcomes related to work- EWCS and 29,404 participants for the KWCS. place mistreatment is estimated to be between $17 and $36 billion annually21), and an Australian study Variables revealed that total national annual employer costs for Mistreatment lost productivity due to depression were estimated at We defined the “Mistreatment” group as individuals AUD$8 billion per annum22). to whom at least one of the following criteria applied: To date, evidence has supported the hypothesis (1) discrimination, that is, being subjected to discrimi- that workplace mistreatment has negative effects on nation at work because of age, ethnicity, sex, nation- employees’ health. However, most of these studies ality, or religion in the past 12 months; (2) violence, have been based on Western samples. Although work- that is, being subjected to verbal abuse, unwanted place mistreatment shares similar characteristics, other sexual attention, threats and humiliating behavior, or related research suggests that responses to workplace physical violence during the course of work in the mistreatment may be different in Eastern
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