146 Chapter 5 may take advantage of privacy-sensitive information of employees due to the unequal relationship between a supervisor and employee: S13 (socio-political macro level): “And I think that is quite a disturbing development, because then you have to remember that this happens constantly in an unequal relationship. The employment relationship is simply one where the employer has obvious authority, so there is an unequal relationship where an employee often acts submissive to what an employer expects, and certainly people with a low socioeconomic status. Because your contract could not be extended, or you will receive a bad evaluation. And that also results in a rather complicated and therefore not properly regulated domain for which I have no solution, but I do see the risks.” Therefore, several stakeholders described that an OHP is important to advise and guide employees, independently of other interests. Moreover, some stakeholders stated that it is difficult for supervisors to be fully responsible for employees’ health and safety, as they are not allowed to discuss health related problems with employees. Though, some stakeholders at organizational and socio-political macro level described that employees usually discuss everything with their supervisor, and that the privacy regulations with regard to discussing problems on multiple life domains are unclear. Discussion This study described the perceptions of different stakeholders on the context for implementation of preventive interventions that consider multiple life domains among employees with a lower SEP. Many organizational and socio-political factors were identified which impede or facilitate implementation and are related to the following themes; (1) the importance of addressing problems on multiple life domains among employees with a lower SEP, (2) unclarity of responsibilities for solving problems on multiple life domains, (3) necessity of better collaboration between occupational and curative healthcare, (4) insufficient investments in prevention by employers, (5) difficulties in early identification of employees at risk for health problems, and (6) risk of conflicting role for supervisors in addressing problems on multiple life domains. This study showed that problems on multiple life domains are considered important to address among employees with a lower SEP. However, stakeholders in this study described that this group of employees has more difficult circumstances in- and outside the workplace to solve their problems. Stakeholders also mentioned that employees with a lower SEP more often have an accumulation of problems that are interrelated and maintain one another. As was described in this study and in literature, they could end up in a vicious cycle, which makes it even more
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