Work characteristics and health in older workers: Educational inequalities

Influence of pension availability on the association between work conditions and labor market exit for health reasons: evidence from a Taiwanese older adults cohort

BACKGROUND

While the impact of poor working conditions on workers' intention to leave the job is well-established, limited research has examined how the availability of pension benefits influences the association between adverse psychosocial work conditions and labor market exit for health reasons among middle-aged and older workers. This study explored the association of psychosocial and physical work conditions with labor market exit for health reasons among individuals with varying pension statuses.

METHODS

This study utilized data from the Healthy Aging Longitudinal Study in Taiwan (HALST), which investigated reasons for labor market exit among 2,143 adults aged 55 and older. Work conditions were aggregated by occupation based on data from the Occupational Safety and Health Surveys, which included nationally representative employees, and subsequently linked to HALST data. We examined the differential impact of psychosocial and physical work conditions on health-related labor market exit, compared to old age retirement, among individuals with and without pension coverage.

RESULTS

Among 2,143 study participants, 7.3% left the labor market due to health reasons, and 39.9% reported not having a pension. Individuals with low job control (adjusted odds ratio [aOR] = 2.23, 95% confidence interval [CI] = 1.05 to 4.73) and high physical demands (aOR = 2.72, 95% CI = 1.26 to 5.85) were more likely to exit the labor market for health reasons compared to old age retirement. Among participants without a pension, adverse work conditions were significantly associated with labor market exit for health reasons.

CONCLUSIONS

Adverse work conditions were associated with labor market exit for health reasons particularly among older adults without pension coverage. Implementing policies to improve psychosocial work conditions and enhance the pension system is warranted.

A resource-oriented perspective on the aging workforce - exploring job resource profiles and their associations with various health indicators

BACKGROUND

Promoting older workers' health in the context of increasing labor force participation and skill shortages is crucial. Examining job resource profiles offers a promising approach to understanding how to promote and maintain the health of older workers within the workplace. However, it is unclear how different job resources interact within distinct worker subgroups. Thus, this study explores the association between the job resource profiles of distinct subgroups and various health indicators among older workers in Europe.

METHODS

Data from 4,079 older workers (age range: 50-60 years, 57% female) from waves 6 and 8 of the Survey of Health, Ageing and Retirement in Europe (SHARE) were analyzed. Latent profile analysis was employed to identify distinct job resource profiles using social support, recognition, job promotion, autonomy, and development opportunities. Associations between these profiles and various health indicators were examined, alongside the sociodemographic and socioeconomic characteristics associated with each profile.

RESULTS

Four distinct job resource profiles emerged: (I) average job resource workers (n = 2170, 53%), (II) high social job resource workers (n = 983, 24%), (III) low job resource workers (n = 538, 13%), and (IV) autonomous decision-making workers (n = 388, 10%). Workers in the (II) high social job resource profile had the highest socioeconomic status and reported the best self-perceived health, lowest depressive symptoms, and fewest limitations and chronic diseases. Conversely, workers in the (III) low job resource profile had the second-lowest socioeconomic status and reported the poorest health outcomes. Surprisingly, older workers with high autonomy (profile IV) had the lowest socioeconomic status and the second worst self-perceived health. This may be because they perceive themselves as autonomous while lacking support and recognition.

CONCLUSION

There is wide variation in the level and composition of resources available to older workers in the workplace. The most vulnerable subgroups, such as low job resource workers (profile III) and autonomous decision-making workers (profile IV), could benefit from tailored workplace health promotion interventions, such as support from supervisors or peers. Strengthening older workers' job resources, including social support and recognition, can improve their health and contribute to them remaining in the workforce.

The impact of social activities on mental health among older adults in China

Background

Understand the current situation of social activities among older adults and its impact on mental health, providing policy basis and intervention measures to improve the mental health of the older adult.

Method

Collect relevant data from 8,181 older adults aged ≥ 60 years old from the 2020 China Health and Retirement Longitudinal Study (CHARLS), constructing an analysis framework for social activities of older adults in China from three aspects: participation in social activities, number of social activities, frequency of social activities, and describe them, then analyzing the impact of social activities on their mental health using OLS and 2SLS regression models. This study also discusses the impact of eight social activities on the mental health of older adult people through subgroup.

Result

Among 8,181 older adults aged 60 and above, 3,808 participated in social activities (56.24%), average number of social activities is 0.71, and average frequency of social activities is 1.31 times. The average score of mental health level measured by CES-D is 15.24 points. Participate in social activities can reduce the depression level of the older adult (β = -0.352, 95%CI: -0.547~-0.158); the more social activities the older adult participate in, the lower the depression level of the older adult (β = -0.214, 95%CI: -0.313~-0.115); the higher the frequency of participating in social activities, the lower the depression level of the older adult (β = -0.133, 95%CI: -0.182~-0.083). In summary, social activities can improve the mental health level of the older adults in China. As for different types of social activities, visiting and socializing with friends, participating in club organization activities, playing mahjong, chess, cards, or going to community activity rooms and attending school or training courses can improve the mental health of the older adult.

Discussion

The social activities in three dimensions among older adults in China need to be further improved, and participating in social activities can help improve their mental health. The conclusion provides important policy implications for encouraging and supporting older adults to participate in various social activities, increasing the number and frequency of older adult social activities, then help improving the mental health level of older adults.

Sex and gender differences in depressive symptoms in older workers: the role of working conditions

BACKGROUND

Female older workers generally leave the work force earlier than men. Depressive symptoms are a risk factor of early work exit and are more common in women. To extend working lives, pathways leading to these sex inequalities need to be identified. The aim of this study was to investigate the association of sex and gender with depressive symptoms in older workers, and the role of working conditions in this association.

METHODS

We used data from the Longitudinal Aging Study Amsterdam (2012-2013/2015-2016, n = 313). Our outcome was depressive symptoms, measured by the Center for Epidemiologic Studies Depression Scale. We included biological sex, a gender index ranging from masculine to feminine (consisting of six items measuring gender roles: working hours, income, occupation segregation, education, informal caregiving, time spent on household chores), and working conditions (physical demands, psychosocial demands, cognitive demands, autonomy, task variation, social support) in our models. We examined the differential vulnerability hypothesis, i.e., sex/gender moderates the association between working conditions and depressive symptoms, and the differential exposure hypothesis, i.e., working conditions mediate the association between sex/gender and depressive symptoms.

RESULTS

Female sex and feminine gender were both associated with more depressive symptoms. The differential vulnerability hypothesis was not supported by our results. We did find that femininity was negatively associated with autonomy and task variation. In turn, these working conditions were associated with fewer depressive symptoms. Thus, autonomy and task variation partially mediated the association between gender and depressive symptoms, supporting the differential exposure hypothesis. Mediation effects for sex inequalities were not significant.

CONCLUSIONS

Older female workers and older feminine workers have more depressive symptoms than their male/masculine counterparts. Autonomy and task variation appeared to be important in - partially - explaining gender differences in depressive symptoms rather than sex differences. By improving these conditions, gender inequality in mental health among older workers can be reduced, so that both genders have similar chances to reach the retirement age in good mental health.

The association between sociodemographic characteristics and the event of undergoing first-time, simple lumbar discectomy: A case-control study

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Educational level and pre-OP sick leave affect the probability of lumbar discectomy.

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Discectomy is more common with low socioeconomic status compared to high status.

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Sociodemographic factors should be noted for their importance in choice of treatment.

Background

In disc herniation, nonsurgical treatments are recommended prior to elective discectomy but are often associated with consultation fees, whereas the discectomy itself may be without user payment. This may affect individual preferences in the choice of treatment. This retrospective case-control study examined the association between socioeconomic characteristics and the event of undergoing a first-time, single-level, simple lumbar discectomy.

Methods

The consecutively formed study population comprised patients undergoing elective lumbar discectomy at a Danish public hospital between 2010 and 2013. A national authority identified three gender- and age-matched controls per case for comparison. Measures investigated in this study were marital status, ethnicity, socioeconomic classification, educational level, the extent of sick leave 52 weeks prior to surgery, personal income, and equivalized disposable household income. All measures were provided by national registries. The associations were examined using uni- and multivariate logistic regression analysis.

Results

In a study population of 888 operated patients (age (SD) 46 (14); ODI (SD) 47 (18); leg pain intensity (VAS) (iqr) 74 (33), EQ-5D (iqr) 0.26 (0.62)) compared to 2664 controls, the probability of undergoing lumbar discectomy was significantly associated with lower vs. higher educational levels ((OR 1.98-2.53), and with periods of sick leave exceeding two weeks within one year prior to surgery (OR 9.47 (95% CI 7.68-11.68)). In the multivariate analysis, the event of undergoing discectomy was insignificantly associated with any other socioeconomic characteristics, whereas the personal income was of significant importance in the univariate analysis.

Conclusion

The event of undergoing free-of-fee elective first-time, single-level, simple lumbar discectomy is more common among individuals with low educational levels and unstable labor market attachment when examined in a case-control study. Being a multifactorial challenge, this calls upon the active engagement of several policy sectors.

Do overweight/obesity and low levels of leisure-time vigorous physical activity moderate the effect of occupational physical activity on self-rated health of construction workers?

Purpose

To investigate the combined effects of occupational physical activity (OPA) and either overweight/obesity or low levels of leisure-time vigorous physical activity (LTVPA) on self-rated health.

Methods

A longitudinal study was performed among 29,987 construction workers with complete data on 2 Workers’ Health Surveillance Programs during 2010–2018. Self-reported OPA involved strenuous work postures and manual material handling. Low level of LTVPA was defined as self-reported vigorous activity for less than three times per week lasting at least 20 min per session. Overweight and obesity were based on Body Mass Index (BMI) (25.0 ≤ BMI < 30.0 kg/m² and BMI ≥ 30.0 kg/m², respectively) using measured body height and weight. Self-rated health was measured using a single item question. Logistic regression analysis was used to investigate the associations between the separate risk factors at baseline and self-rated health at follow-up. The combined effects of demanding OPA and either overweight/obesity or low level of LTVPA on self-rated health were analyzed using the relative excess risk due to interaction (RERI).

Results

Mean follow-up duration was 31.7 (SD = 14.9) months. Construction workers with strenuous work postures (OR 1.35 95% CI 1.25–1.46), manual material handling (OR 1.29 95% CI 1.19–1.40), obesity (OR 1.31 95% CI 1.17–1.47) and low LTVPA (OR 1.13 95% CI 1.01–1.25) were more likely to report poor self-rated health at follow-up. No statistically significant interaction effects were found for OPA and obesity or low LTVPA.

Conclusions

OPA, obesity and low level of LTVPA were separate risk factors for poor self-rated health, but did not appear to have a synergistic effect.