64 Chapter 3 be more important among workers with a low SEP than among workers with a high SEP, and the workplace could provide an opportunity to increase this. Work and non-work-related determinants may also result in work-family conflicts, wherein family demands (i.e. non-work-related determinants) interfere with work life, and vice versa. Unfavorable work-related determinants such as shift work or less flexible work could negatively affect the family life (38). Inversely, unfavorable non-work-related determinants, such as an unhealthy lifestyle could negatively affect the working life (39). Work-family conflicts are associated with a higher sickness absence (40, 41) and poorer health outcomes (41, 42). Especially among workers with a low SEP, work-family conflicts seem to have a more negative effect on health, compared to workers with a high SEP (43). Hence, workers with a low SEP are simultaneously exposed to a variety of unfavorable determinants (6, 44). Interventions that focus only on work-related determinants ignore the interconnections between these determinants and are less likely to be effective (44). Third, poor health literacy to adapt these work and non-work-related determinants. Workers with a low SEP tend to have poor health literacy, which means that they have less cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways that promote and maintain good health (33, 45). As a result, workers with a low SEP may find it difficult to self-manage and adapt unfavorable circumstances in or outside the workplace, which could be caused by a lack of motivation or self-efficacy for their ability to adapt unfavorable circumstances (46). Moreover, poor health literacy could also result from a lack of awareness and a lower risk perception of health problems. Workers with a low SEP hardly think about their own sustainable employability (19), which was also recognized in the interviews. Workers with a low SEP mentioned that it was difficult to be aware of a problem and to act on it. Especially when they were able to work, they may not recognize the value or importance of changing unfavorable determinants for work functioning and health. Poor health literacy may lead to passive or avoidant coping styles towards health problems. Research shows that people with a higher SEP show a more active attitude towards their health status, whereas people with a low SEP focus more on acceptance instead of facing the challenges (22). This could also be enhanced by the more difficult circumstances workers with a low SEP may face due to problems on multiple life domains. It may be harder for workers with a low SEP to act on these circumstances, making it easier to accept them. As a result, workers with a low SEP may be too late in addressing health problems, which could increase the risk for premature dropout from the labor market (47).
RkJQdWJsaXNoZXIy MTk4NDMw