Report 3 - Exploring the Link Between Work-Life Conflict and Demands on Canada's Health Care System

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ISBN 0-662-38365-6

Our mission is to help the people of Canada maintain and improve their health.
Health Canada

Report Three: Exploring the Link Between Work-Life Conflict and Demands on Canada's Health Care System was prepared by Dr. Chris Higgins, Professor, Richard Ivey School of Business, University of Western Ontario, Dr. Linda Duxbury, Professor, Sprott School of Business, Carleton University and Karen Johnson, PhD Candidate, Sprott School of Business, Carleton University, for the Healthy Communities Division, Public Health Agency of Canada. The opinions expressed in this report are those of the authors and do not necessarily reflect the views of Health Canada.

Funded by Health Canada.

Report Three:

March 2004

Table of Contents

• Acknowledgements
• Forward
• Theoretical Framework
• The Report Series
• Organization of Report Three
• Executive Summary

Chapter One

• Introduction
  • 1.1 Objectives of the Research
  • 1.2 Why Do We Need a Study Like This One?

Chapter Two

• Background
  • 2.1 How Much Does It Cost to Keep Canadians Healthy?
    • 2.1.1 Who pays for health care?
    • 2.1.2 How much does Canada spend on health care compared to other countries?
  • 2.2 Models That Can Be Used to Frame the Discussion
    • 2.2.1 Workplace health promotion
    • 2.2.2 The Population Health Model
    • 2.2.3 The Index of Social Health
  • 2.3 Workplace Health
    • 2.3.1 Why invest in workplace health?
    • 2.3.2 Why are organizations and governments not addressing workplace health issues?

Chapter Three

• Methodology
  • 3.1 Who Responded to the "National Study on Balancing Work, Family and Lifestyle?"
  • 3.2 Measurement of Key Constructs
    • 3.2.1 Health and health care outcomes
  • 3.3 Data Analysis
  • 3.4 Reporting Protocols Followed in This Report

Chapter Four

• How Do Canadian Employees See Their Health?
  • 4.1 Perceived Health
  • 4.2 Impact of Work-Life Conflict on Perceived Health
  • 4.3 Summary: Perceived Health

Chapter Five

• How Does Work-Life Conflict Affect the Use of Canada's Health Care System?
  • 5.1 Visits to the Physician
  • 5.2 Visits to Other Health Care Professionals
  • 5.3 Visits to Mental Health Professionals
  • 5.4 Visits to Hospital: Inpatient Care
  • 5.5 Visits to Hospital: Emergency Department
  • 5.6 Visits to Hospital/Clinic on an Outpatient Basis for Tests/Procedures
  • 5.7 Impact of Work-Life Conflict on Use of the Health Care System
    • 5.7.1 Impact of role overload on the use of Canada's health care system
    • 5.7.2 Impact of work to family interference on the use of Canada's health care system
    • 5.7.3 Impact of family to work interference on the use of Canada's health care system
    • 5.7.4 Impact of caregiver strain on the use of Canada's health care system
  • 5.8 Summary: Use of the Health Care System

Chapter Six

• Estimate of the Health Care Costs Associated with HighWork-Life Conflict
  • 6.1 Model for Socio-Economic Assessment of Work-Life Conflict
  • 6.2 Health Care-Related Costs of High Role Overload
  • 6.3 Health Care-Related Costs of High Work to Family Interference
  • 6.4 Health Care-Related Costs of High Family to Work Interference
  • 6.5 Health Care-Related Costs of High Caregiver Strain
  • 6.6 Summary

Chapter Seven

• Impact of Work-Life Conflict on Prescription Drug Use
  • 7.1 Use of Prescription Medicine in Canada
  • 7.2 Use of Prescription Medicine by Employed Canadians
  • 7.3 Link Between Prescription Drug Use and Work-Life Conflict
  • 7.4 Summary

Chapter Eight

• Conclusions and Recommendations
  • 8.1 Benchmarking the Current State of Affairs
  • 8.2 Impact of Gender, Job Type, Sector of Employment and Dependent Care
  • 8.3 Role Overload
  • 8.4 Work to Family Interference
  • 8.5 Family to Work Interference
  • 8.6 Caregiver Strain
  • 8.7 Conclusions and Recommendations
    • 8.7.1 Recommendations to governments
    • 8.7.2 Recommendations to employers

References

Appendices

• Appendix A: History of Thinking Around Health Care in Canada
• Appendix B: Perceived Health and Use of the Health Care System
  • Results Obtained for Total Sample
  • Comparison: Gender by Job Type
  • Comparison: Gender by Dependent Care Status (DCS)
  • Comparison: Gender by Sector of Employment
• Appendix C: Impact of Work-Life Conflict on Health Outcomes
• Appendix D: Relative Risk of Work-Life Conflict
• Appendix E: Calculating the Costs to the Health Care System of Work-Life Conflict

List of Tables

• Table 1: Health-Related Costs of Work-Life Conflict
• Table 2: Summary of Between-Group Differences in Health Outcomes
• Table E1: Costs of Work-Life Conflict: Physician Visits
• Table E2: Costs of Work-Life Conflict: Inpatient Hospital Stays
• Table E3: Costs of Work-Life Conflict: Emergency Room Visits

List of Figures

• Figure 1: Theoretical Framework
• Figure 2: Perceived Health for Total Sample
• Figure 3: Impact of Work-Life Conflict on Perceived Health
  • (a) Percentage who say health is very good/excellent
  • (b) Percent who say health is fair/poor
• Figure 4: Percent of Respondents Using Different Facets of the Health Care System
  • (a) Visits to Physician, Use of Emergency Department, Medical Tests on Outpatient Basis
  • (b) Inpatient Hospital Stays, Visits to Mental Halth Professionals
  • (c) Visits to Other Health Care Professionals
• Figure 5: Impact of High Role Overload on Use of Canada's Health Care System
• Figure 6: Impact of High Work to Family Interference on Use of Canada's Health Care System
• Figure 7: Impact of High Family to Work Interference on Use of Canada's Health Care System
• Figure 8: Impact of High Caregiver Strain on Use of Canada's Health Care System
• Figure 9: Three Perspectives on the Economic Costs of Work-Related Stress
• Figure 10: Amount Spent on Prescription Drugs in a Six-Month Period
• Figure 11: Impact of Work-Life Conflict on Prescription Drug Use