Although not significant, the findings from this study showed that employed women reported better health status than the housewives in all domains of quality of life except for physical functioning. The findings also hghlighted the fact that the differences were more related to psychological health (role emotional, vitality and mental health) rather than physical health. In fact employment status provided a better psychological health for women when it was compared to non-employed women. Unfortunatetly we did not collect the data on type and employment conditions, but it is argued that not all employment conditions could provide health benefits for women. A prospective study of 21290 female registered nurrses found that low job condition, high job demands, and low work related social support were associsiated with poor health statusat at baseline as well as greater functional declines over the four years follow-up period . However, there might be other reasons for non-significant differences in quality of life between employed women and housewives. For example, the rather low power of the current study (small sample size) could be one reason for such findings.
Interestingly the housewives reported better physical functioning compared to the employed women. It is argued that one reason for low physical functioning among employed women might be due to work-related stress that in turn even could predict sick-leave among employed women .
The findings from our study were consistent with the results of similar studies conducted in Iran [12, 16, 17]. For example, a recent study of 710 working mothers and 350 non-working women from Iran on the impact of emplyment on mothers’ health status found that after adjustment for three main explanatory factors (socio-demographic, work and work-related, and social-life context variables) there were no statistically significant differences between working and non-working women in a range of mental and physical health outcome variables. The authors concluded that this might be a result of the counter-balance of the positive and negative factors associated with paid work such as increased stress on one hand and self-esteem on the other . However, the comparison of quality of life scores between our study population and a sample of Iranian female population showed that the mean score for different quality of life domains in our sample was lower than that of those for the Iranian women population except for physical functioning and mental health .
The contemporary women fulfill multiple roles: housewife, partner, parent and caregiver to elders, and worker in the labor force. Within the framework of theoretical models of ‘role’, the relationship between employment and women's health status has been addressed by two major approaches: role strain, and role enhancement. The former argues that multiple roles might have negative effects on women’s psychological well-being, while the latter argues that engaging in multiple roles enhances women’s mental well-being . It seems that the findings from the current study are in favor of the role enhancement approach. In fact this approach emphasizes on women's employment as an additive role to their traditional role; and it is considered as a positive matter. Positive effects of women's employment are probably achieved through increased self esteem, higher income and wider social support.
In general there is a long-standing debate that whether housewives or working wives are happier and healthier. The results obtained from a cross-national data from 28 countries using multi-level analyses showed that housewives were slightly happier than wives who work full time. The cross-level interactions between employment status, and social indicators at country levels also indicated that the disadvantage in happiness for full time working wives improved compared to housewives and part-time workers . Perhaps in the future it might be helpful to examine the topic in the context of the work-family enrichment theory. It studies the extent to which experiences in one role improve the quality of life in the other role .
This study had some limitations. Firstly it was a cross sectional study and thus making the findings limited. Secondly, there were some confunders for which we did not collect data. For instance we did not collect information on psychological status of the women at the time of completing the questionnaire. Finally, for illiterate women we did collect the data by interviews while for others we used the self-completion method. Thus the results might be influenced by difference in data collection.