Adverse health behaviors are an increasingly important public health problem.
Although the development in health behaviors and risk factors has long been positive (Vartiainen et al. 2000), partially adverse trends have recently been observed in body mass index and alcohol consumption, for instance (Kastarinen et al. 2007). As health behaviors and risk factors explain over half of the mortality from coronary heart disease (Jousilahti et al. 1995, Laatikainen et al. 2005), they compose a relevant motive for further studies. Additionally, while, on one hand, health behaviors largely explain educational differences in both cardiovascular and all-cause mortality (Laaksonen et al. 2007), the transforming world of work may, on the other hand, also threaten the health of employees (Kompier 2006). However, a long separate research tradition and extensive body of literature exist in the areas of both health behaviors and working conditions, whereas studies combining these research traditions are dispersed and have produced inconclusive results (Netterstrøm et al. 1991, Hellerstedt
& Jeffery 1997, Otten, Bosma & Swinkels 1999, Siegrist & Rödel 2006).
The four key health behaviors, i.e., smoking, drinking, physical activity and food habits, as well as related obesity are elements of lifestyle and have been considered together as behaviors that are at least partly voluntary (Blaxter 1990, Laaksonen, Prättälä & Karisto 2001). Patterns of these health behaviors can be seen as being based on choices from available options according to life situation (Cockerham, Abel
& Lüschen 1993). More importantly, these behaviors also are determinants of subsequent health and well-being (Breslow 1999, Hu et al. 2005, Patja et al. 2005), although they were initially emphasized in disease prevention only (Kasl & Cobb 1966a, Kasl & Cobb 1966b). It has been suggested that while present social, cultural, and economical conditions promote uncertainty and diversity in these lifestyle choices, they also push people toward greater individual responsibility (Cockerham, Rütten & Abel 1997).
Work-related issues are of importance as well, since people spend a large part of their active time in work, highlighting the significance of various working conditions, such as physical and psychosocial exposures for health behaviors and health of employees (Stansfeld & Marmot 2002, Belkic et al. 2004, Kivimäki et al. 2006, Siegrist & Rödel 2006, Stansfeld & Candy 2006). Furthermore, working conditions have undergone dramatic changes during the previous decades (Frese 2000, Stellman 2003, Kompier 2006). While physical demands at work have diminished, psychological and psychosocial demands have increased with the growing complexity of modern society (Theorell 2000). Both these factors may have deleterious health consequences, as the sedentary employees (Brown, Miller & Miller 2003) are further threatened with psychosocially strenuous working conditions (Ferrie et al. 1998, Stansfeld et al. 1998, Marmot, Theorell & Siegrist 2002). New challenges also include modern technologies, while physical and chemical exposures still pose hazards for many employees (Hemström 2001, Ylikoski et al. 2006). Therefore, the current situation emphasizes a need to identify both physical and psychosocial conditions in work that potentially act as contributors of employees’ behaviors, weight, and subsequent health.
The challenge of the research in this area is, however, that health behaviors also occur outside work. Nevertheless, they impact weight, physical symptoms, and well-being
of employees and subsequently their work ability and productivity. This highlights the importance of gaining new evidence about the contribution of the working conditions to the modifiable, preventable, behavioral risk factors. One might hypothesize that with high levels of physical activities, other health behaviors, and maintenance of healthy weight, employees can better do their work, while prevention of lifestyle-related chronic diseases can also be achieved. Additionally, it is necessary to seek efficient ways to promote healthy weight among employees by elucidating understanding of the work-related correlates of weight gain and obesity. Some workplace factors may bear potential for beneficial influence as well by, for instance, contributing to healthier food habits (Lallukka, Lahti-Koski & Ovaskainen 2001, Roos, Sarlio-Lähteenkorva & Lallukka 2004).
Especially concerning women, previous studies about the associations between working conditions, work-related factors, and behavioral risk factors are largely lacking, but are of importance as during the previous decades women have increasingly entered the workforce outside their homes (Blau 1998, Ylikoski et al.
2006). Women may, therefore, face even more demanding situations than men due to multiple roles at work and at home (Barnett 2004). Furthermore, the relationship between psychosocial working conditions and behavioral risk factors is likely to be complicated by the simultaneous demands of family roles (Brezinka, Kittel 1995, Lai 1995, Artazcoz, Borrell & Benach 2001). Accordingly, work-related factors such as work-home interface, as well as social support (Sarason et al. 1983, Sarason et al.
1987) need to be examined alongside the working conditions.
Since socio-economic indicators are also linked with working conditions (Schrijvers et al. 1998), it has been suggested that improved working conditions might help reduce socio-economic inequalities in health among employees, i.e., health inequalities may originate from the workplace (Vahtera et al. 1999). Also other later studies imply that the known socio-economic inequalities in health may originate from the workplace (Chandola, Brunner & Marmot 2006). More specifically, the known relationship between occupational social class and health is assumed to be mediated by psychosocial working conditions (Rahkonen et al. 2006). The extent to which the generally socially-patterned behaviors are also correspondingly determined or explained by working conditions warrants, however, further investigation. This is of importance, as adverse health behaviors have been found to be frequent among employees in Finland (Talvi et al. 1998), but show potential for improvements in work-site intervention (Talvi, Järvisalo & Knuts 1999).
Multidimensional explanation profiles, e.g., both psychosocial and physical working conditions, and work-home interface, are innovatively applied in this study. The emphasis is, however, on the psychosocial working conditions. Additionally, a specific emphasis is on increasing understanding about the significance of working conditions for female employees. Most of the previous studies have only examined male populations, single workplaces, one or a few behaviors, or included limited information about working conditions. It is important, therefore, to deepen, clarify, and update our understanding about the significance of various working conditions for employees’ health-related behaviors and symptoms.
The main focus of this study is on key behavioral risk factors and on how working conditions might be associated with health behaviors and physical symptoms among
employees. Increasing understanding about working conditions as assumed determinants of behavioral risk factors is needed, in order to prevent the chronic diseases morbidity and mortality, as well as to promote better health and prevent physical symptoms among employees. In addition to focusing on adverse behaviors which are established determinants of future morbidity, early retirement, and mortality (Neubauer et al. 2006), this study also aims to identify work-related factors associated with healthy behaviors that are likely to contribute to health and maintenance of work ability.