Abstract

To investigate the association between hours of remote work (RWHs) and housework (HWHs), independently, as well as the combined total of work hours (WHs), with gender and mental health of remote workers during the COVID-19 pandemic. Cross-sectional study with data from the ELSA-Brasil (N = 2,318). On average, women reported more time spent on HWHs and WHs than men, while no difference was found in RWHs. Depression, anxiety and stress were more prevalent among women. Women with longer working hours (RWHs, HWHs and WHs) had higher odds of displaying anxiety or stress symptoms than men with shorter working hours. For symptoms of depression, the highest odds ratios were found only among those women with medium or long HWHs and long WHs. A gender perspective into studies of remote work effects has contributed to the recognition of health inequalities between men and women.

Palavras-chave:
Ansiedade; Depressão; Estresse; Atividade doméstica; Carga de trabalho

Resumo

Investigar associações das horas de trabalho remoto (TR) e doméstico (TD), separadamente e combinadas (TT), com o gênero e o sofrimento mental de trabalhadores em trabalho remoto durante a pandemia de COVID-19. Estudo transversal com dados do ELSA-Brasil (N = 2.318). Em média, mulheres referiram mais tempo de TD e TT do que os homens, mas não foi observada diferença de gênero quanto ao TR. Depressão, ansiedade e estresse foram mais frequentes nas mulheres. Mulheres com jornadas mais longas (TR, TD e TT) apresentaram maiores chances de sintomas de ansiedade e estresse do que os homens com jornadas mais curtas. Para os sintomas de depressão, as razões de chance mais altas foram observadas apenas entre as mulheres com moderada ou longa jornadas de TD e TT. A perspectiva de gênero quanto ao efeito do trabalho remoto contribui para o reconhecimento de iniquidades em saúde entre homens e mulheres.

Palavras-chave:
Ansiedade; Depressão; Estresse; Atividade doméstica; Carga de trabalho

Resumen

Investigar las asociaciones de las horas de trabajo remoto (TR) y horas de trabajo doméstico (TD), separadas y combinadas (TT), con el género y la salud mental de los trabajadores que trabajan de forma remota durante la pandemia de COVID-19. Estudio transversal con datos de lo ELSA-Brasil (N = 2.318). En promedio, las mujeres reportaron más tiempo de TD y TT que los hombres, pero no se observó diferencia entre géneros en términos de horas de TR. Depresión, ansiedad y estrés fueron más frecuentes en las mujeres. Las mujeres con jornadas laborales más largas (TR, TD y TT) tenían más probabilidades de experimentar síntomas de ansiedad y estrés que los hombres con jornadas laborales más cortas. Para los síntomas de depresión, los odds ratios más altos se observaron sólo entre mujeres con recorridos TD y TT moderados o largos. La perspectiva de género en los estudios sobre el efecto del trabajo remoto contribuye al reconocimiento de las inequidades en salud entre hombres y mujeres.

Palabras clave:
Ansiedad; Depresión; Estrés; Actividad doméstica; Carga de trabajo

Introduction

One of the strategies adopted to contain the spread of COVID-19 was social distancing¹1 Aquino EML, Silveira IH, Pescarini JM. Aquino R, Souza-Filho JA, Rocha AS, Ferreira A, Victor A, Teixeira C, Machado DB, Paixão E, Alves FJO, Pilecco F, Menezes G, Gabrielli L, Leite L, Almeida MCC, Ortelan N, Fernandes QHRF, Ortiz RJF, Palmeira RN, Junior EPP, Aragão E, Souza LEPF, Netto MB, Teixeira MG, Barreto ML, Ichihara MY, Lima RTRS. Social distancing measures to control the COVID-19 pandemic: potential impacts and challenges in Brazil. Cien Saude Colet 2020; 25(Supl. 1):2423-2446.^,22 Wilder-Smith A, Freedman DO. Isolation, quarantine, social distancing and Community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med 2020; 27(2):taaa020.. Prominent among the measures recommended was for various kinds of work to be performed from home³3 Arntz M, Ben Yahmed S, Berlingieri F. Working from home and COVID-19: the chances and risks for gender gaps. Inter Econ 2020; 55(6):381-386.^,44 Araújo TM, Lua I. O trabalho mudou-se para casa: trabalho remoto no contexto da pandemia de COVID-19. Rev Bras Saude Ocupacional 2021 ;46:e27., which had impacts on how men and women workers were required to organise their work and lives⁵5 Biroli P, Bosworth S, Della Giusta M, Di Girolamo A, Jaworska S, Vollen J. Family life in lockdown. Front Psychol 2021; 12:687570.. In that scenario, it became more common to engage in housework, with many taking on care for the home and children in a context where schools were closing and third party support, from maids and relatives, was lacking⁶6 Guedes M, Cordeiro MC. Confinamento, desigualdade e trabalho: o cuidado como atributo feminino. In: Bitencourt SM, Estevinho TAD, organizadores. Sociologia por temáticas: tecendo diálogos em artesanias contemporâneas. Cuiabá: EdUFMT, 2021; p. 229-254..

These working arrangements during the pandemic have been associated with certain adverse effects on mental health³3 Arntz M, Ben Yahmed S, Berlingieri F. Working from home and COVID-19: the chances and risks for gender gaps. Inter Econ 2020; 55(6):381-386.^,55 Biroli P, Bosworth S, Della Giusta M, Di Girolamo A, Jaworska S, Vollen J. Family life in lockdown. Front Psychol 2021; 12:687570.^,77 Sentürk E, Sagaltici E, Genis B, Günday Toker Ö. Predictors of depression, anxiety and stress among remote workers during the COVID-19 pandemic. Work 2021; 70(1):41-51.^,88 Xue B, McMunn A. Gender differences in unpaid care work and psychological distress in the UK Covid-19 lockdown. PLoS One 2021; 16(3):e0247959.. On the other hand, the perception of greater autonomy in managing time can have positive effects on job satisfaction⁹9 Sousa Uva M, Sousa Uva A, Sampayo MM, Serranheira F. Telework during the COVID epidemic in Portugal and determinants of job satisfaction: a cross-sectional study. BMC Public Health 2021; 21:227.^,1010 Niebuhr F, Borle P, Börner-Zobel F, Voelter-Mahlknecht S. Healthy and happy working from home? Effects of working from home on employee health and job satisfaction. Int J Environ Res Public Health 2022; 19(3):1122., which is strongly associated with mental health1¹¹11 Bulinska-Stangrecka H, Bagienska A. The role of employee relations in shaping job satisfaction as an element promoting positive mental health at work in the Era of COVID-19. Int J Environ Res Public Health 2021; 18(4):1903. https://doi.org/10.3390/ijerph18041903
https://doi.org/10.3390/ijerph18041903... . Indeed, data from 28 European Union countries show advantages and disadvantages of remote work during the pandemic, which vary with demographic and work-related factors¹²12 Ipsen C, van Veldhoven M, Kirchner K, Hansen JP. Six Key Advantages and Disadvantages of Working from Home in Europe during COVID-19. Int J Environ Res Public Health 2021; 18(4):1826..

It has been suggested that gender differences exist in relations between remote work and health⁸8 Xue B, McMunn A. Gender differences in unpaid care work and psychological distress in the UK Covid-19 lockdown. PLoS One 2021; 16(3):e0247959.. The activity of caring for the family is attributed primarily to women, who thus suffer different impacts from that affecting men¹³13 Wenham C, Smith J, Morgan R. Gender and COVID-19 Working Group. COVID-19: the gendered impacts of the outbreak. Lancet 2020; 395(10227):846-848.. One English study of a sample mostly engaged in remote work showed that, among those who had no prior mental health problems, being a woman, under 45 years old, working part-time and having two dependents were among the predictors of stress and depressive symptoms; the men, meanwhile, reported more conflict between personal life and work¹⁴14 Platts K, Breckon J, Marshall E. Enforced home-working under lockdown and its impact on employee wellbeing: a cross-sectional study. BMC Public Health 2022; 22(1):199.. Similarly, the need for social distancing can lead to a worsening of existing mental health inequalities between men and women⁸8 Xue B, McMunn A. Gender differences in unpaid care work and psychological distress in the UK Covid-19 lockdown. PLoS One 2021; 16(3):e0247959..

In countries such as Brazil, where care for home and children is preponderantly women’s responsibility¹⁵15 Agência Brasil. IBGE: mulher tem peso importante no chamado "trabalho invisível" [Internet]. 2020. [acessado 2021 dez 20]. Disponível em: https://agenciabrasil.ebc.com.br/economia/noticia/2020-06/ibge-mulher-tem-peso-importante-no-chamado-trabalho-invisivel
https://agenciabrasil.ebc.com.br/economi... , the absence of time and place boundaries between work and home life during the pandemic is likely to have had greater impact on women⁴4 Araújo TM, Lua I. O trabalho mudou-se para casa: trabalho remoto no contexto da pandemia de COVID-19. Rev Bras Saude Ocupacional 2021 ;46:e27.. Studies of time use during the pandemic in various countries, including Brazil, described women’s devoting more time to demands of the home, especially when they had children¹⁶16 Giurge LM, Whillans AV, Yemiscigil A. A multicountry perspective on gender differences in time use during COVID-19. Proceedings Nat Acad Sci 2021; 118(12):e2018494118.. The authors of a study of work activities pursued at home in the context of the COVID-19 pandemic argued that the attribution of positive aspects to remote work may derive, among other factors, from a lack of attention to gender issues, which are rarely considered in studies⁴4 Araújo TM, Lua I. O trabalho mudou-se para casa: trabalho remoto no contexto da pandemia de COVID-19. Rev Bras Saude Ocupacional 2021 ;46:e27.. A study of workers in remote work situations during the COVID-19 pandemic showed that, among both men and women, lack of control over work time was associated with stress, anxiety and depression¹⁷17 Griep RH, Almeida MCC, Barreto SM, Brunoni AR, Duncan BB, Giatti L, Mill JG, Molina MCB, Moreno AB, Patrão AL, Schmidt MI, Fonseca MJM. Working from home, work-time control and mental health: Results from the Brazilian longitudinal study of adult health (ELSA-Brasil). Front Psychol 2022; 13:993317..

Considering that (i) remote work during the pandemic entails a working all day in a setting that demands extra home care and (ii) housework is done mostly by women, the hypothesis of this study is that women find it more difficult to reconcile job and housework than men and, accordingly, are more likely to display mental suffering. This study examines the associations of hours spent on remote work and on housework independently, and also hours spent on the two types of work combined, with gender and mental health - symptoms of anxiety, stress and depression - of workers in remote work situations during the COVID-19 pandemic.

Methods

Study population

The Longitudinal Study of Adult Health (ELSA-Brasil) is a Brazilian cohort followed in order to assess the incidence and progression of chronic diseases, focusing on cardiovascular diseases and diabetes, among civil servants from six different institutions in Brazil. This cross-sectional study used data from a study supplementary to ELSA-Brasil designed to assess the short- and long-term impact of COVID-19 and social policies to control it on the health of ELSA-Brasil participants. Between July 2020 and February 2021, the ELSA-Brasil cohort participants at the Rio de Janeiro, Salvador, Belo Horizonte, Espírito Santo and Porto Alegre study sites were sent invitations to answer online questionnaires by way of an application developed especially for the study, with the assistance of a trained, certified team, resulting in a total sample of 5,639 respondents. This is a subsample of the ELSA-Brasil obtained through voluntary adherence¹⁷17 Griep RH, Almeida MCC, Barreto SM, Brunoni AR, Duncan BB, Giatti L, Mill JG, Molina MCB, Moreno AB, Patrão AL, Schmidt MI, Fonseca MJM. Working from home, work-time control and mental health: Results from the Brazilian longitudinal study of adult health (ELSA-Brasil). Front Psychol 2022; 13:993317.. Of these, 3,043 (54%) were active workers who responded to job-related questions. Those who reported not being engaged in remote work (n = 725) were excluded. The final study sample comprised 2318 participants (1,163 women and 1155 men).

Variables

Description

Remote working hours (RWHs) was evaluated by the question: “On average, how many hours a week do you spend working at home, not counting housework?” Terciles were used as cutoff points and the variable was categorised into “short RWHs”, “medium RWHs” and “long RWHs”.

Housework hours (HWHs) was evaluated by the question: “Since the start of social distancing, on average how many hours a week do you spend on housework?” Terciles were used as cutoff points and the variable was categorised into “short HWHs”, “medium HWHs” and “long HWHs”.

Total working hours (WHs) was evaluated by combining remote working hours and housework hours. The variable was produced by adding weekly remote work and housework hours. Terciles were used as cutoff points and the variable was categorised into “short WHs”, “medium WHs” and “long WHs”.

Outcome

Symptoms of anxiety, stress and depression were evaluated by applying the depression, anxiety and stress scale (DASS-21). The DASS-21 comprises three Likert-type subscales of four scores (ranging from 0: “Does not apply to me” to 3: “Applies to me very much or most of the time”). Each subscale comprises seven items, designed to evaluate states of depression, anxiety and stress¹⁸18 Vignola RCB, Tucci AM. Adaptation and validation of the Depression, Anxiety and Stress Scale (DASS) to Brazilian Portuguese. J Affect Disord 2014; 155:104-109.. Scores on each subscale were calculated by adding the items, multiplying by two and categorising into five groups: normal, mild, moderate, severe and extremely severe. Based on the literature¹⁹19 Hernández-Yépez PJ, Muñoz-Pino CO, Ayala-Laurel V, Contreras-Carmona PJ, Inga-Berrospi F, Vera-Ponce VJ, Failoc-Rojas VE, Pereira-Victorio CJ, Valladares-Garrido MJ. Factors associated with anxiety, depression, and stress in Peruvian University Students during the COVID-19 pandemic. Int J Environ Res Public Health 2022; 19(21):14591.

20 García-Portilla P, de la Fuente Tomás L, Bobes-Bascarán T, Treviño LJ, Madera PZ, Álvarez MS, Miranda IM, Álvarez LG, Martínez PAS, Bobes J. Are older adults also at higher psychological risk from COVID-19? Aging Ment Health 2021; 25(7):1297-1304.^-2121 Miller RL, Pallant JF, Negri LM. Anxiety and stress in the postpartum: is there more to postnatal distress than depression? BMC Psychiatry 2006; 6:12., for this study, the “mild”, moderate”, “severe” and “extremely severe” categories were grouped by each of the three symptoms (depression, anxiety and stress), so as to produce dichotomous variables (symptom absent; symptom present).

Covariables

Age (in complete years), marital status (married/cohabiting; single/separated/widowed), per capita income (in reals), schooling (up to complete secondary; higher education /specialisation; masters/doctorate), caring for children and/or ill and/or elderly persons (No; Yes).

Data analysis

In describing the study sample, categorical variables were expressed as absolute and relative frequencies, while continuous variables were expressed as means and standard deviations (SDs). Associations between variables were tested using the Pearson chi-square test for categorical variables and the Mann-Whitney test for numerical variables. Odds ratios (ORs) and their respective 95% confidence intervals (95%CI) were estimated by means of logistic regression models adjusted for age, income and marital status and specified on the basis of variables that showed associations in the bivariate analyses. As interaction (p < 0.05) was found between gender and the different kinds of working hours in their association with mental health outcomes, ORs were estimated for each stratum of working hours and gender combined, taking men with short working hours as the reference category (that is, the stratum with least risk of the outcome). In other words, for the associations between working hours (RWHs, HWHs and WHs) and mental suffering (symptoms of depression, anxiety and stress), each of the three types of working hours (RWHs, HWHs and WHs) was grouped by participant gender, so as to obtain a six-category variable: Men with short RWHs, Men with medium RWHs, Men with long RWHs, Women with short RWHs, Women with medium RWHs and Women with long RWHs. The same classification method was used for HWHs and WHs.

All statistical analyses were stratified by gender and performed using the software R, version 3.6.1.

Results

The study participants were 1,163 women and 1155 men. As compared with the men, the women were younger (54.9 [SD = 7.3] vs 55.5 [SD = 7.5] years), more often single/separated/widowed (48.6% vs 19.2%), had higher income (5020.7 [SD = 3,533.7] vs 4652.1[SD = 2943.7] reals), more schooling (89.5% vs 87.2% with higher education or more) and cared more often for children and/or ill and/or elderly people (39.1% vs 34.8%). The three symptoms of mental suffering were statistically more present among the women than among the men - depression (24.7% vs 18.7%), anxiety (20.4% vs 10.6%) and stress (20.1% vs 11.7%), respectively (Table 1).

As regards remote work and housework, the women were found, on average, to spend more hours on housework (15.4 hours/week vs 12.0 hours/week; p < 0.01) and total work (35.9 hours/week vs 32.8 hours/week; p = 0.01) than the men, while no statistically significant difference was found as regards remote work (20.5 hours/week vs 20.6 hours/week; p = 0.624). In the presence of anxiety symptoms, the women returned larger percentages than the men of long RWHs (38.1% vs 24.8%) and long WHs (41.9% vs 26.8%). In the presence of stress symptoms, percentage long RWHs was larger among the women than among the men (42.7% vs 30.8%) (Table 2).

Table 3 shows the results from the regression models for the associations between working hours and mental suffering, adjusted for age, income and marital status. As compared with men with short HWHs, the odds of displaying symptoms of depression were found to be greater among men with long HWHs (OR = 1.54; 95%CI: 1.02; 2.32), women with medium HWHs (OR = 1.55; 95%CI: 1.04; 2.31) and women with long HWHs (OR = 1.71; 95%CI: 1.17; 2.55). In addition, women with long WHs were 1.5 more likely (OR = 1.51; 95%CI 1.03; 2.24) to display symptoms of depression than men with short WHs.

Statistically significant results were also found for anxiety symptoms. As compared with men with short RWHs, women with short, medium or long RWHs, returned greater odds of displaying anxiety symptoms. Similarly, women with short, medium or long HWHs were more likely to display anxiety symptoms than men with short HWHs. Both men with long RWHs (OR = 0.40; 95%CI: 0.21; 0.69) and those with long WHs (OR = 0.47; 95%CI: 0.26; 0.82) returned higher odds of displaying anxiety symptoms than men with short working hours (Table 3).

As compared with men with short working hours, the odds of reporting stress symptoms were higher among women with medium or long RWHs than among those with medium or long HWHs (Table 3).

Discussion

The appraisal of remote work during the pandemic, considering hours of remote work and housework, pointed to significant associations between working hours and mental suffering, primarily among the women. In all modalities of working hours (RWHs, HWHs or WHs), women with longer working hours returned greater odds of presenting symptoms of anxiety or stress than men with short working hours. Specifically as regards symptoms of depression, the highest odds were found only among women with medium or long HWHs and long WHs.

The higher prevalence of mental suffering found here among the women is no surprise, given the findings in the literature. A review of the literature on mental health problems during the COVID-19 pandemic showed that women returned greater odds of mental suffering than men²²22 Hossain MM, Tasnim S, Sultana A, Faizah F, Mazumder H, Zou L, McKyer E, Ahmed HU, Ma P. Epidemiology of mental health problems in COVID-19: a review. F1000 Res 2020; 9:636.. Similar findings (being female associated with higher levels of depression, anxiety and stress) have been observed in other populations²³23 Mazza C, Ricci E, Biondi S, Colasanti M, Ferracuti S, Napoli C, Roma P. A Nationwide Survey of Psychological Distress among Italian People during the COVID-19 Pandemic: Immediate Psychological Responses and Associated Factors. Int J Environ Res Public Health 2020; 17(9):3165.^,2424 Tee ML, Tee CA, Anlacan JP, Aligam KJG, Reyes PWC, Kuruchittham V, Ho RC. Psychological impact of COVID-19 pandemic in the Philippines. J Affect Disord 2020; 1(277):379-391.. Overall, also as regards periods prior to the COVID-19 pandemic, the literature reports that mental health problems are observed among men and women, but not in the same proportion. As found in this study, a systematic review of cohort studies carried out in Germany found that mental health outcomes are generally more frequent among women than among men, which can be attributed to biological differences and gender roles²⁵25 Otten D, Tibubos AN, Schomerus G, Brähler E, Binder H, Kruse J, Ladwig K-H, Wild PS, Grabe HJ, Beutel ME. Similarities and Differences of Mental Health in Women and Men: a Systematic Review of Findings in Three Large German Cohorts. Front Public Health 2020; 9:553071..

The findings of this study corroborate the discussions of heightened gender inequalities under social distancing⁸8 Xue B, McMunn A. Gender differences in unpaid care work and psychological distress in the UK Covid-19 lockdown. PLoS One 2021; 16(3):e0247959.. Reduced walking and increased time spent on childcare were associated with greater risk of depression among women in remote work. Among men, however, remote work attenuated the risk of depression²⁶26 Sato K, Sakata R, Murayama C, Yamaguchi M, Matsuoka Y, Kondo N. Changes in work and life patterns associated with depressive symptoms during the COVID-19 pandemic: an observational study of health app (CALO mama) users. Occup Environ Med 2021; 78(9):632-637..

Remote work seems to constitute a more challenging situation for women, because women still bear greater responsibility for housework, including caring for the home and children⁶6 Guedes M, Cordeiro MC. Confinamento, desigualdade e trabalho: o cuidado como atributo feminino. In: Bitencourt SM, Estevinho TAD, organizadores. Sociologia por temáticas: tecendo diálogos em artesanias contemporâneas. Cuiabá: EdUFMT, 2021; p. 229-254.. Accordingly, remote working can be seen to blur work-life boundaries, which can also raise levels of stress and anxiety²⁷27 Xiao Y, Becerik-Gerber B, Lucas G, Roll SC. Impacts of Working From Home During COVID-19 Pandemic on Physical and Mental Well-Being of Office Workstation Users. J Occup Environ Med 2021; 1:63(3):181-190.. Although no differences were found between men and women as regards RWHs hours worked, the women’s HWHs was longer than the men’s. Therefore, the greater overload observed among the women resulted from housework, showing that, for women, remote working entails meeting different demands, often simultaneously, resulting in greater emotional wear. It is important to note that the recommendation to stay at home during the pandemic led whole families to live together more intensely and without respite (except during sleep). For men, on the other hand, the home environment still represents a place of few responsibilities, which became their workplace during the period of social distancing²⁸28 Vicente TA, Rotenberg L. Home-office e desigualdades de gênero em docentes universitários na pandemia de covid-19. Rev Bras Cienc Soc 2023; 8(111):e3811012 2023..

This study found a striking contrast between the genders as regards the anxiety data. Taking the men with short working hours as the reference group, men with long RWHs and long WHs returned less than half the odds of displaying anxiety symptoms, while among the women, the corresponding odds were practically double (RWHs) or more than double (WHs). When thinking about this intriguing finding, it should be considered that these are cross-sectional data, analysis of which began on the assumption that overwork can affect mental health. On the other hand, however, it can be supposed that gender differences do exist in relations between working hours and mental health, so that anxiety may have influenced how men conducted their working day. In that light, men with anxiety symptoms would be less likely to work long remote and total hours, which would explain the study findings. This is one possibility among others, to be explored in future studies.

Although conducted during the pandemic period, this study contributes to the gender discussions that are still incipient in the literature as a whole. As regards work activities performed at home, most studies did little to address gender-related aspects, hindering full comprehension of the impacts of remote work on health during social distancing⁴4 Araújo TM, Lua I. O trabalho mudou-se para casa: trabalho remoto no contexto da pandemia de COVID-19. Rev Bras Saude Ocupacional 2021 ;46:e27.. Generally speaking, considering that HWHs are longer among women than among men¹⁵15 Agência Brasil. IBGE: mulher tem peso importante no chamado "trabalho invisível" [Internet]. 2020. [acessado 2021 dez 20]. Disponível em: https://agenciabrasil.ebc.com.br/economia/noticia/2020-06/ibge-mulher-tem-peso-importante-no-chamado-trabalho-invisivel
https://agenciabrasil.ebc.com.br/economi... ^,2929 Molarius A, Metsini, A.Domestic Work, Self-Reported Diagnosed Depression and Related Costs among Women and Men - Results from a Population-Based Study in Sweden. Int J Environ Res Public Health 2021; 18(18):9778. and that it is women who continue to be overloaded with housework, which has adverse effects on mental health³⁰30 Maeda E, Nomura K, Hiraike O, Sugimori H, Kinoshita A, Osuga Y. Domestic work stress and self-rated psychological health among women: a cross-sectional study in Japan. Environ Health Prev Med 2019; 24(1):75., it is possible that remote work is more difficult for women than for men. On the other hand, some women’s assessment is that the possibility of working from home strengthens family ties and leaves more time for physical and leisure activities³¹31 Lemos AHC, Barbosa AO, Monzato PP. Mulheres em home office durante a pandemia da Covid-19 e as configurações do conflito trabalho-família. RAE 2020; 60(6):388-399.. Accordingly, the findings of this study offer more input to discussions of gender differences.

The study also has its limitations. Despite the cross-sectional nature of the analyses, the direction of the association examined here, considering hours worked to be the exposure, rests on the plausibility of such relations, in that there are reasons to suppose that more time devoted to remote work and to housework leads to mental suffering. Note, however, the findings as regards anxiety: there, the association with working hours (in remote work and total hours) may have been in the opposite direction. In addition, people with different mental health-related problems before the onset of the pandemic may have been more vulnerable to adverse mental health outcomes²⁵25 Otten D, Tibubos AN, Schomerus G, Brähler E, Binder H, Kruse J, Ladwig K-H, Wild PS, Grabe HJ, Beutel ME. Similarities and Differences of Mental Health in Women and Men: a Systematic Review of Findings in Three Large German Cohorts. Front Public Health 2020; 9:553071.. It is also noteworthy that in the Brazilian context, the lack of alignment between the WHO recommendations to reduce transmission of the virus and the measures adopted in the country made it difficult to control the pandemic, which may have contributed to the mental suffering of the population. Another important limitation has to do with sources of stress and determinants of mental disorders during the pandemic, which were not addressed in this study. Loss of friends and relatives, fear of falling ill and dying, concern over one’s own health and that of people who are close are other factors that can affect mental health. Gender differences are also observed in that context, in that not only has housework been increased by the recommendations for sanitising environments and food, but also the role of caregiver exposes women to greater risk of infection through more intensive contact with relatives who are ill³²32 Özdin S, Bayrak Özdin S. Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. Int J Soc Psychiatry 2020; 66(5):504-511

33 Pan American Health Organization (PAHO). Gendered Health Analysis: COVID-19 in the Americas [Internet]. 2021. [cited 2022 maio 31]. Available from: https://iris.paho.org/handle/10665.2/55432
https://iris.paho.org/handle/10665.2/554... ^-3434 Wang Y, Di Y, Ye J, Wei W. Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychol Health Med 2021; 26(1):13-22.. Also, as this study is based on a subsample of the ELSA-Brasil obtained by voluntarily completing an online questionnaire, it is possible that a self-selection bias occurred.

Despite the divergences among municipal, state and federal spheres in the approach to coping with the pandemic, also with regard to the recommendation of social distance, this sample of civil servants from universities and a research institution started remote work right at the beginning of the pandemic, which suggests a homogeneity regarding the remote work practice addressed in the present study.

In short, this study highlights the fact that, in remote work during the pandemic, the various modalities of working hours (RWHs, HWHs and WHs) are associated with mental suffering, particularly among women. Incorporation of a gender approach in studies contributes to recognition of health inequalities between men and women.

References

Publication Dates

History