Gendered work-family trajectories and depression at older age

Work-family trajectories across Europe: differences between social groups and welfare regimes

Introduction

Work and family trajectories develop and interact over the life course in complex ways. Previous studies drew a fragmented picture of these trajectories and had limited scope. We provide the most comprehensive study of early-to-midlife work-family trajectories to date.

Methods

Using retrospective data from waves 3 and 7 of the Survey of Health, Aging and Retirement in Europe (SHARE), we reconstructed work-family trajectories from age 15 to 49 among almost 80,000 individuals born between 1908 and 1967 across 28 countries. We applied multichannel sequence and cluster analysis to identify typical trajectories and multinomial logistic regression models to uncover their social composition.

Results

The results revealed six common trajectories. The dominant and therefore standard trajectory represents continuous full-time employment with having a partner and children. Women, the lower educated and persons from conservative and liberal welfare regimes are underrepresented in this trajectory, whereas men, higher educated people and those from social-democratic, Eastern European and Baltic welfare regimes are overrepresented. The other trajectories denote a deviation from the standard one, integrating a non-standard form of work with standard family formation or vice versa. Mothers in a stable relationship generally work part-time or not at all. When mostly in full-time employment, women are more likely to be divorced. Lower educated persons are less likely to have work-family trajectories characterized by full-time work and a non-standard family, yet more likely to be non-employed for large parts of their life with standard family formation. Younger cohorts are underrepresented in non-employment trajectories, but overrepresented in part-time employment trajectories along with a partner and children as well as full-time employment trajectories with divorce. Individuals from Southern European and liberal regimes are more likely to be non-working and self-employed partnered parents and those from social-democratic regimes are more likely to be full-time employed divorced parents. We also found pronounced gender differences in how educational level, birth cohort and welfare regime are associated with work-family trajectories from early to midlife.

Discussion

Our findings highlight the socially stratified nature of earlier-life work-family trajectories in Europe. Potential implications for inequalities in later life are discussed.

Uncovering the Work-Family Interface: The Impact of Facilitators and Stressors on the Health of Farm Women

Work-family interface (WFI) theory has identified many stressors that influence work-family dynamics from the standpoint of employees. However, work-family facilitators, as well as the effects of gender differences and the impact of sociocultural environments that differ from a formal employment situation, have received much less attention. Our research aimed to fill these theoretical gaps by analyzing the facilitators and stressors involved in work-family dynamics and determining their consequences for farm women's physical, psychological, and social health. We used a qualitative method with a grounded theory design to collect data via semi-structured interviews with 46 farm women from the region of Araucanía in Chile. Our results explain how facilitators, stressors, and outcomes take place in a process of work-family balance that, paradoxically, implies exhausting journeys, a gender-based overload, a risk of diffuse body pain and distress, and a lack of time for personal healthcare and productive autonomy. Addressing these issues requires a comprehensive approach involving improved healthcare infrastructure and services focused on changing the pressures that the farming WFI exerts on rural women.

Risk Factors and Short-Term Prognosis of Lymphocele After Kidney Transplant

OBJECTIVES

Lymphocele is a frequent complication after kidney transplant and needs attention. This study was undertaken to analyze perioperative risk factors and short-term outcomes associated with lymphocele after kidney transplant.

MATERIALS AND METHODS

Our single-center study retrospectively analyzed 264 recipients of kidney allografts from January 2018 to October 2021. Patients were classified into 2 groups according to the occurrence of lymphocele. Perioperative clinical data and follow-up indicators were compared between groups.

RESULTS

The incidence of lymphocele after kidney transplant was 19.7%. Univariate analysis showed that percentage of male patients, hypothermic machine perfusion proportion, and postoperative hemoglobin and albumin were lower and flow velocity of renal artery was higher in the lymphocele group compared with the control group. Multivariate logistic regression revealed that postoperative hemoglobin <95 g/L (odds ratio = 2.01; 95% confidence interval, 1.01-4.05; P = .03) was an independent risk factor and hypothermic machine perfusion (odds ratio = 0.27; 95% confidence interval, 0.08-0.96; P = .04) was a protective factor for the determination of lymphocele. Comparisons of related complications indicated that drainage tube and urinary catheter removal times were longer and urinary tract infection and moderate to severe anemia proportions were higher in the lymphocele group. Follow-up data showed that postoperative 1-month serum creatinine was higher and 1-month estimated glomerular filtration rate was lower in lymphocele group compared with the control group, but no significant differences were shown at 12 months.

CONCLUSIONS

Postoperative hemoglobin may be a risk factor and hypothermic machine perfusion may be a protective factor for lymphocele after kidney transplant. Lymphocele only temporarily affects short-term kidney function, especially during hospitalization.

Work-family trajectories in young adulthood: Associations with mental health problems in adolescence

During young adulthood, several transitions in work and family lives occur, but knowledge of the work-family trajectories of the current generation of young adults, i.e. people born in the 1990s, is lacking. Moreover, little is known about whether the mental health status before the start of the working life may shape work-family trajectories. We used 18-year follow-up data from the TRAILS cohort study of individuals born between 1989 and 1991 (n = 992; 63.2% women). Internalising and externalising problems were measured with the Youth Self-Report at ages 11, 13 and 16 years. Monthly employment, education and parenthood states were recorded between 18 and 28 years. Applying sequence analysis, we identified six work-family trajectories in women and men. The first five trajectories were labelled: long education, continuous education and work, education and work to work, early work, and inactive. The main difference between trajectories of women and men was in the timing of parenthood, thus the remaining trajectory of women was labelled active with children, and the remaining trajectory of men active. Women who experienced externalising problems in adolescence were more likely to belong to the trajectory characterised by parenthood. Men who experienced internalising problems in adolescence were more likely to belong to the trajectory characterised by a long time spent in education. The TRAILS data allowed us to consider timing, duration and ordering of the work and family states in young adulthood, and to use multiple assessments of mental health in adolescence. Further research needs to examine the mechanisms through which early mental health affects later work and family outcomes.

Adulthood Employment Trajectories and Later Life Mental Health before and after the Onset of the COVID-19 Pandemic

BACKGROUND

This life course study has two aims. First, to explore how diverse employment trajectories across adulthood are related to older people's mental health in Chile, a country with no research in this field, and second, to analyze these associations before and after the onset of the COVID-19 pandemic.

METHODS

We use data from the nationally-representative and longitudinal 'Chilean Social Protection Survey' sequence analysis to reconstruct employment trajectory types, and bivariate and multivariate analyses to measure their association with depressive symptoms.

RESULTS

Our findings indicate that formal labor force patterns in adulthood show the lowest burden of depressive symptomology before and after the onset of the overwhelming COVID-19 pandemic when controlling for traditional risk factors.

CONCLUSION

We emphasize that policymakers in both the labor market and public health domains must consider the relationship between informal employment pathways in adulthood and poorer mental health in old age. Public policies should improve the conditions and quality of jobs during adulthood and promote more formalization in the labor market to address the high uncertainty involving low social protection, which is strongly associated with severe mental health problems in later life.

Gendered work-family life courses and late-life physical functioning: A comparative analysis from 28 European countries

Combining work and family roles can have beneficial consequences on health but could also result in chronic stress and adverse health outcomes at older ages. This study aimed to examine combined employment, parenthood, and partnership histories of men and women during the childbearing period (ages 15-49), and to investigate the links of these work and family roles with physical functioning later in life. We used data from the Survey of Health, Ageing and Retirement in Europe (SHARE) with retrospective information on employment, parenthood, and partnership histories for 18,057 men and 20,072 women (n = 38,129) living in 28 different countries belonging to six European welfare clusters. We applied multichannel sequence analysis (MCSQA) and hierarchical clustering to group work-family trajectories into 12 clusters for men and 15 clusters for women. We assessed the association between work-family life courses and grip strength by estimating multivariable linear regression models. Delayed work and family transitions, unstable employment, and the absence of combinations of work and family roles between age 15 and 49 were associated with weaker grip strength in later life for both men and women. Results differed by gender and were framed by the welfare context in which gendered work and family responsibilities unfold across individual life courses. The findings make an important contribution to the domain of gender and health in later life and stress the need to engage more with issues related to the mechanisms linking work and family trajectories to poor health in later life.

Simultaneous employment and depressive symptom trajectories around retirement age in Chile

Objectives: Over the last decade, an increasing number of empirical studies have examined long-term patterns of depression among adults around retirement age and identified employment status as a crucial determinant. However, most research has examined associations between cross-sectional measures of employment and prospective depression patterns, overlooking the changing nature of employment statuses, particularly close to retirement age. Furthermore, most knowledge in this field comes from studies conducted in developed countries in Western Europe and North America. To address these gaps, this study examined simultaneous trajectories in the employment and depressive symptom domains among two age groups of Chileans before and after the standard retirement age. Method: Using population-representative data and longitudinal statistical methods, we identified different trajectory types among two age groups (one aged 56-65 and another aged 66-75, at baseline) and characterized them according to social and health characteristics.Results: We found that trajectories defined by permanent employment were accompanied by lower depressive symptoms than trajectories indicating either retirement or inactivity. However, trajectories combining employment and the absence of depressive symptoms were primarily followed by individuals with advantaged health and social statuses at the baseline. Conclusion: Public policies aimed at promoting the mental health of older adults through their labor market integration risk forcing individuals who have accumulated social and health disadvantages across the life course to work longer.

Work-family trajectories and health: A systematic review

BACKGROUND

Work and family lives interact in complex ways across individuals' life courses. In the past decade, many studies constructed work-family trajectories, some also examined the relation with health. The aims of this systematic review were to summarise the evidence from studies constructing work-family trajectories, and to synthesise the evidence on the association between work-family trajectories and health.

METHODS

We searched MEDLINE, EMBASE, PsycINFO, SocINDEX and Web of Science databases. Key search terms related to work, family and trajectories. Studies that built combined work-family trajectories or examined the relationship between work and family trajectories were included. Risk of bias was assessed independently by two authors. The identified work-family trajectories were summarised and presented for men and women, age cohorts and contexts. The evidence on the association with health as antecedent or consequence was synthesised.

RESULTS

Forty-eight studies, based on 29 unique data sources, were included. Thirty-two studies (67%) were published in 2015 or later, and sequence analysis was the primary analytic technique used to construct the trajectories (n = 43, 90%). Trajectories of women were found to be more diverse and complex in comparison with men. Work-family trajectories differed by age cohorts and contexts. Twenty-three studies (48%) examined the association between work-family trajectories and health and most of these studies found significant associations. The results indicate that work-family trajectories characterised by an early transition to parenthood, single parenthood, and weak ties to employment are associated with worse health outcomes.

CONCLUSIONS

Work-family trajectories differed greatly between men and women, but differences seemed to decrease in the youngest cohorts. Given the current changes in labour markets and family formation processes, it is important to investigate the work and family lives of younger cohorts. Work-family trajectories were associated with health at different life stages. Future research should examine longitudinal associations of work-family trajectories with health and focus on elucidating why and under which circumstances some trajectories are associated with better or worse health compared with other trajectories.

Childbearing Biographies and Midlife Women's Health

OBJECTIVES

We introduce a "childbearing biography" approach to show how multiple childbearing characteristics cluster in ways significant for midlife health.

METHODS

We analyze the National Longitudinal Survey of Youth 1979 (NLSY79; N = 3992) using mixed-mode Latent Class Analysis with eight childbearing variables (e.g., age at first birth, parity, birth spacing, and mistimed births) to identify how childbearing biographies are associated with midlife health, adjusting for key covariates-including socioeconomic status (SES) and relationship history.

RESULTS

We identify six childbearing biographies: (1) early compressed, (2) staggered, (3) extended high parity, (4) later, (5) married planned, and (6) childfree. Childbearing biographies are strongly associated with physical health but not mental health, with differences primarily explained by SES.

DISCUSSION

Different childbearing biographies are related to physical health inequalities above what is demonstrated by the typical use of one or two childbearing measures, providing a new perspective into the growing health gap among aging midlife women.

Multiple social roles in early adulthood and later mental health in different labour market contexts

Work and family roles entail divergent responsibilities, which can be a source of conflict especially in young adulthood - the so-called "rush-hour" of life. Combining these multiple social roles can result in an accumulation of stress but also be a valuable resource for mental health. The aim of this study is to investigate combined employment, parenthood and partnership trajectories of men and women during early adulthood, and to analyse the relationship of these multiple roles with depressive symptoms at older age. We used harmonised data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and the English Longitudinal Study of Ageing (ELSA) with retrospective information on employment, partnerships and parenthood histories between age 25 and 40 for 18,816 men and 24,686 women (n = 43,502). We applied sequence analysis and clustering to group trajectories into four clusters for women and three clusters for men. We then used multilevel models to analyse the links between combined employment and family roles and later mental health in different historical labour market contexts (indicated by female employment rates). Women and men who did not combine work and family roles between age 25 and 40 report higher levels of depression than those who combined work and family. Results differ by gender and labour market context, with stronger differences between women in countries with higher female employment rates. Overall, combining multiple roles in early adulthood is associated with decreased rather than increased risk for depressive symptoms in older Europeans.

Work-family life courses and psychological distress: Evidence from three British birth cohort studies

This study uses multi-channel sequence analysis to characterize work-family life course types between the ages of 16 and 42, and multivariable logistic regression to examine their association with psychological distress at age 42/43 for men and women in three nationally-representative British birth cohorts born in 1946 (N = 2,858), 1958 (N = 9,140), and 1970 (N = 7,095). We hypothesised that work-family life courses characterized by weaker links to employment and earlier transitions to partnerships and parenthood would be associated with a greater probability of psychological distress at age 42, and that this association would be become more pronounced across cohorts. Levels of psychological distress were higher amongst men and women with weaker long-term ties to employment, although these were largely explained by early life factors. Teen mothers had higher levels of psychological distress in the two later-born cohorts, and this remained unexplained in adjusted models for the 1970 cohort.

Lifetime employment histories and their relationship with 10-year health trajectories in later life: evidence from England

Background

Employment histories influence health. However, most studies have so far investigated cross-sectional associations between employment histories and health, failing to recognize health as a dynamic process in later life.

Methods

We use Waves 3–8 of the English Longitudinal Study of Ageing, including retrospective information on respondents’ employment activities. We used dynamic hamming distances to summarize lifetime employment histories up to state pension age (64 for men and 59 for women). Multilevel growth curve models were then used to estimate the influence of lifetime employment histories on later life health trajectories over a 10-year period using quality of life (QoL), somatic health, and depression.

Results

Net of selection effect and a host of contemporaneous material and social resources, men who exited early started off with poorer health than those with continuous attachment to the labour market but had a very similar health profile by the end of the 10-year period considered. Among women, better somatic health and higher QoL were observed among those who had employment breaks for family care, and this health advantage was maintained over time. Lifetime employment histories are not related to depression for either men or women.

Conclusion

Overall, differences in health by employment histories level off only among men who left earlier and those continuously employed. Flexible arrangements for men in poor health who benefit from leaving the labour market early and supporting women who wish to take breaks for family care may help reduce health inequalities in later life.

None the wiser: Year-long longitudinal study on effects of adversity on wisdom

Research on consequences of adversity appears inconclusive. Adversity can be detriment to mental health, promoting maladaptive patterns of thoughts. At the same time, posttraumatic growth studies suggest that overcoming major adversity facilitates growth in wisdom-related patterns of thoughts. We address this puzzle by examining how distinct types of adversity impact wisdom over time and how individual differences in self-distanced (rather than self-immersed) reflection on adversity relate to different wisdom trajectories. In a four-wave prospective year-long study, participants ( N = 499) recalled and reflected every three months on the most significant recent adverse event in their life. They reported how much they engaged in wise reasoning—intellectual humility, open-mindedness to diverse perspectives and change, search for compromises and resolution—as well as self-distancing during reflections. Independent raters identified seven distinct adversity types (e.g. social conflict, economic hardship, major trauma) in open-ended descriptions. Growth curve analyses revealed little evidence of positive change in wise-reasoning over the course of a year, and some evidence of negative change for health-related adversity. Although self-distancing was associated with stability in wisdom, self-immersing was associated with negative change in wisdom in reflections on social conflicts over time. We discuss implications these results have for adversity, change vs. resilience in character strengths, and self-distancing.

Lifetime employment, tobacco use, and alcohol consumption trajectories and cardiovascular diseases in old age

Despite the great advances of life course epidemiology studies during the last decade in understanding the general health effects of employment trajectories, research has yet to evaluate the effects of employment trajectories along with other major risk factors, such as tobacco and alcohol consumption, on cardiovascular diseases (CVDs)-the main cause of deaths worldwide. This is highly relevant, since health advantages in one domain (e.g., being a permanent formal full-time worker) may offset health disadvantages in other domains (e.g., being a regular smoker or alcohol consumer); conversely, disadvantages in both domains may interact, leading to even greater health risks. Considering these knowledge gaps, this research has two main objectives: (1) to reconstruct simultaneous employment, tobacco use, and alcohol consumption trajectories over the life course (from birth to old age) and (2) to measure the association between these trajectories and CVD in old age. Drawing on a rich and comprehensive life history dataset and using multichannel sequence and regression analyses, we analyzed a cohort of individuals aged 65-75 in Chile, a Latin American country with high social inequalities and scarce research on this matter. Our study shows that following a trajectory of formal employment together with no tobacco and alcohol use reduces CVD risk by 36 percentage points relative to a similar employment trajectory but with regular tobacco and alcohol use. Even with an employment trajectory characterized by constant informal employment or permanent inactivity, a life course free of regular tobacco and alcohol use shows protective effects against CVD. This study stresses the importance of health policies that consider CVD as a condition that strongly depends on individual experiences in multiple life domains and across different life stages.

The moderating role of psychosocial working conditions on the long-term relationship between depressive symptoms and work ability among employees from the Baby Boom generation

Objective

Mental disorders have been identified as a leading cause for reduced work ability in industrialized countries. Identification of workplace factors that can increase the work ability of employees with depressive symptoms from the Baby Boom generation is, therefore, highly relevant. This study thus aims to investigate whether changes in psychosocial working conditions can moderate the negative association between depressive symptoms and work ability.

Methods

Two waves with a 3-year time lag of the German lidA cohort study with 3609 participants born in 1959 and 1965 (aged 46 and 52 years at first wave) were analyzed. Self-report data about depressive symptoms at baseline and changes of working conditions from baseline to follow-up were used to calculate main and interaction effects on perceived work ability at follow-up. These analyses were controlled for baseline work ability and working conditions.

Results

Depressive symptoms were predictive for an unfavorable course of work ability from baseline to follow-up (B = − 0.173, 95% CI = − 0.219 to − 0.128). However, no interaction effect between depressive symptoms and psychosocial working conditions was found. Instead, independent from the level of depressive symptoms, a decrease in quantitative demands (B = − 0.279, 95% CI = − 0.326 to − 0.232) and increases in leadership quality (B = 0.242, 95% CI = 0.192–0.292) and development opportunities (B = 0.177, 95% CI = 0.127–0.277) were related to a more favorable course of work ability. Only small effects were found for social support (B = 0.057, 95% CI = 0.008–0.106) and job control (B = 0.043, 95% CI = − 0.005–0.091).

Conclusions

The results indicate that the lagged and negative effect of depressive symptoms on work ability was not moderated by changes in psychosocial working conditions. However, the promotion of favorable working conditions may contribute to a positive development of work ability among employees from the Baby Boom generation independently from the level of depressive symptoms.

Electronic supplementary material

The online version of this article (10.1007/s00420-020-01570-1) contains supplementary material, which is available to authorized users.

Women's Work-Family Histories and Cognitive Performance in Later Life

Long-term exposures to the stress and stimulation of different work, parenting, and partnership combinations might influence later life cognition. We investigated the relationship between women's work-family life histories and cognitive functioning in later life. Analyses were based on data from women born between 1930 and 1957 in 14 European countries, from the Survey of Health, Ageing and Retirement in Europe (2004-2009) (n = 11,908). Multichannel sequence analysis identified 5 distinct work-family typologies based on women's work, partnership, and childrearing statuses between ages 12 and 50 years. Multilevel regressions were used to test the association between work-family histories and later-life cognition. Partnered mothers who mainly worked part-time had the best cognitive function in later life, scoring approximately 0.63 (95% confidence interval (CI): 0.18, 1.07) points higher than mothers who worked full-time on a 19-point scale. Partnered mothers who were mainly unpaid caregivers or who did other unpaid activities had cognitive scores that were 1.19 (95% CI: 0.49, 1.89) and 0.93 (95% CI: 0.20, 1.66) points lower than full-time working mothers. The findings are robust to adjustment for childhood advantage and educational credentials. This study provides new evidence that long-term exposures to certain social role combinations after childhood and schooling are linked to later-life cognition.

Linked work lives: The interrelation of own and partner's employment history and their relationship with mental health in older European couples

INTRODUCTION

There is strong evidence for the importance of previous employment for mental health at older age but little is known about the role of partner's employment history in this. Life course theory suggests that individual trajectories are linked and evidence from cross-sectional studies suggest that there are cross-over effects within couples. Therefore, the present study tests the interdependence of own and partner's employment history and their relationship with depressive symptoms.

METHODS

Analyses are based on retrospective data from the SHARE survey for 5664 long-term couples aged 50 or older, with employment information for each age between 30 and 50 (full-time, part-time, domestic work or non-employed). We use sequence analysis to group similar employment histories and relate own and partner's employment histories with depressive symptoms (EURO-D) using regression models.

RESULTS

Results show that own and partner's employment history are interdependent and mainly follow traditional divisions of paid work, with the majority of men working full-time and women often working part-time or not working. We find increased depressive symptoms after longer episodes of non-employment for men but not for women, regardless of partner's employment situation.

CONCLUSION

The study shows that mental health later in life is related to own employment history and that this relationship is not moderated by partner's employment history. The results need to be interpreted against cultural and gender role norms at the time.

Religiosity and Meditation Practice: Exploring Their Explanatory Power on Psychological Adjustment

There has been increased interest in the relationships between religiosity, meditation practice and well-being, but there is lack of understanding as to how specific religious components and distinct meditation practices could influence different positive and negative psychological adjustment outcomes. The aim of this study was to assess the explanatory power of religious beliefs and the practice of prayer, focused attention (FA), open monitoring (OM), and compassion meditation (CM) on psychological adjustment, taking into consideration a number of practice-related variables such as session length, frequency of practice and lifetime practice. Psychological adjustment was assessed by means of happiness, positive affect, depression, negative affect, and emotional overproduction. A cross-sectional design was used, with a final sample comprising 210 Spanish participants who completed an online assessment protocol. Hierarchical regressions were performed, including age, sex and psychotropic medication use in the first step as possible confounders, with the addition of religious beliefs and the practice of prayer, FA, OM, and CM in the second step. FA session length was related to all psychological adjustment outcomes: happiness (ΔR 2 = 0.09, p = 0.002; β = 0.25, p = 0.001), positive affect (ΔR 2 = 0.09, p = 0.002; β = 0.18, p = 0.014), depression (ΔR2 = 0.07, p = 0.004; β = -0.27, p < 0.001), negative affect (ΔR 2 = 0.08, p = 0.007; β = -0.27, p < 0.001) and emotional overproduction (ΔR 2 = 0.07, p = 0.013; β = -0.23, p = 0.001). CM session length was related to positive affect (β = 0.18, p = 0.011). CM practice frequency was associated with happiness (ΔR 2 = 0.06, p = 0.038; β = 0.16, p = 0.041). Lifetime practice of FA was related to happiness (ΔR 2 = 0.08, p = 0.007; β = 0.21, p = 0.030) and OM to emotional overproduction (ΔR 2 = 0.08, p = 0.037; β = -0.19, p = 0.047). Religious beliefs and prayer seemed to be less relevant than meditation practices such as FA, OM, and CM in explaining psychological adjustment. The distinct meditation practices might be differentially related to distinct psychological adjustment outcomes through different practice-related variables. However, research into other forms of institutional religiosity integrating social aspects of religion is required.