Principle 9
Work-life balance
“Parents and people with caring responsibilities have the right to suitable leave, flexible working arrangements and access to care services. Women and men shall have equal access to special leaves of absence to fulfil their caring responsibilities and be encouraged to use them in a balanced way.”


Work-life balance as a determinant of health
When work becomes an overwhelming part of life, it can put additional time and emotional pressure on those with caring responsibilities and become an unmanageable burden. Conflicts between work and family responsibilities may trigger stress, burn-out, maladaptive coping mechanisms, and overall mental health decline.
On the other hand, flexible and gender-sensitive working and leave arrangements with fair compensation promote workers' psychosocial health, productivity and job retention. Work and meaningful employment also plays a significant role in shaping identities, providing for quality of life and social status.
What does the EPSR Action Plan say?
The EPSR Action Plan sets out five key goals for EU Member States:
The provision of formal early childhood education and care should be increased to ensure that at least 78% of the population aged 20 to 64 is in employment by 2030.
Member States had to transpose the Work-life balance Directive by August 2022.
Social partners should explore measures to ensure fair telework conditions and measures to ensure that all workers can effectively enjoy a right to disconnect.
Public authorities and social partners should cooperate to protect the rights of mobile workers, including seasonal workers.
Member States need to invest in health and care workforce, improving their working conditions and access to training.

Where are we now?
The Social Scoreboard measures progress on the principles of the EPSR. Linked to the principle of childcare and support to children, the Scoreboard outlines that in the EU:
The gender employment gap only decreased by 1 percentage point in the past 10 years (from 11.8 to 10.8).
The employment rate % of population aged 20-64 is at 73.1%.
The gender gap in part-time employment has decreased by 2.8 percentage points in the past 10 years (from 23.5 to 20.7).
*Latest figures - 2021


What are public health actors doing?
The following actions taken by public health actors at (sub)national level can support the implementation of this EPSR principle
Click on a country to learn about initiatives taking place.
What are public health actors doing?
Czech Republic - Accessible and affordable nurseries in the workplace
The General University Hospital in Prague used European Social Funds (2012-2014) to support employees who had babies or young children by founding its own affordable nursery to accommodate their needs.
Priority for places was given to the children of nurses working at the hospital, who are considered the most disadvantaged group among health professionals.

What are public health actors doing?
Wales - The Healthy Working Wales Delivery Model
One of Public Health Wales’s (PHW) objectives for 2030 is to "have influenced main employers in Wales to create good work, maintain employment and invest in staff health and wellbeing." To this end, PHW developed the Healthy Working Wales Delivery Model.
PHW also assessed the health impact of ‘home and agile working in Wales. The assessment demonstrated benefits for some population groups, but also exposed inequalities for others like women, those on low incomes, and care givers.

What are public health actors doing?
Austria - Gender-sensitive workplace health promotion
The Austrian Health Promotion Fund (FGÖ) developed 17 gender-relevant criteria and a 62-point checklist to help employees implement gender-sensitive workplace health promotion. This guidance draws in the gender perspective within health promotion efforts in the workplace, to meet the different needs of workers.
Read more about the development of the criteria in EuroHealthNet Magazine.
What are public health actors doing?
Germany - Flexible working arrangements across hospital settings
The Lutherhaus Protestant Hospital in Essen introduced a scheme of 50 different part-time models, including:
- Qualified part-time employment (15–93% of full-time employment).
- Job-sharing, particularly for managerial functions.
- Coordination of duty rosters of couples across different departments.
- Establishment of time accounts (plus and minus hours).
- Flexible working hours with family-oriented core times.
The Medical University of Hannover provides financial incentives for departments that encourage female doctors to return to work following a year of parental leave.
Northwest Hospital Sanderbusch, Sande, is a member of the network Success Factor Family" and attracts qualified professionals to work in the remote area in which it operates through its “family and children service department”. This department supports child-care solutions, including the option of working partly from home.

EU tools that help implement Principle 9
There are a range of other policies and instruments at the EU level that can help relevant actors in the field, including in public health, to work together to achieve EPSR Principle 9 on work-life balance.
More information about the EU institutions and programmes is available on EuroHealthNet’s Health Inequalities Portal.
The European Care Strategy (communication adopted in September 2022) focuses on EU action to provide high quality accessible and affordable care services for children and people in need of long-term care, and to support decent working conditions for care workers.
For long-term care, policy measures include:
- Developing sustainable long-term care that ensures better and more affordable access to quality services.
- Ensuring adequate social protection for long-term care needs - investing in care services, the improvement of working conditions in the sector, an alleviation of the burden on informal carers.
Revision of the Barcelona targets on early childhood care and education:
- Increase participation in affordable, accessible, and quality early childhood education and care, by revising the Barcelona targets.
Available resources

Have your say
Does your public health institute have any promising policies or practices in place that support the implementation of this EPSR principle?
Send your thoughts to EuroHealthNet's Policy Assistant, Emilia Lindquist at e.lindquist@eurohealthnet.eu.
What's next?
About EuroHealthNet
Building a healthier future for all by addressing the determinants of health and reducing inequalities.
EuroHealthNet is the Partnership of public health agencies and organisations building a healthier future for all by addressing the determinants of health and reducing inequalities. Our focus is on preventing disease and promoting good health by looking within and beyond the health system.
Structuring our work over a policy, a practice, and a research platform, we focus on exploring and strengthening the links between these areas.
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