Can favourable psychosocial working conditions in midlife moderate the risk of work exit for chronically ill workers?: A 20-year follow-up of the Whitehall II study

Maria Fleischmann; Ewan Carr; Stephen A. Stansfeld; Baowen Xue; Jenny Head

doi:10.1136/oemed-2017-104452

Can favourable psychosocial working conditions in midlife moderate the risk of work exit for chronically ill workers? A 20-year follow-up of the Whitehall II study

Maria Fleischmann, Ewan Carr, Stephen A. Stansfeld, Baowen Xue, Jenny Head

Research output: Contribution to journal › Article › peer-review

27 Citations (Scopus)

146 Downloads (Pure)

Abstract

OBJECTIVES: To investigate if favourable psychosocial working conditions can reduce the risk of work exit and specifically for workers with chronic disease.

METHODS: Men and women (32%) aged 35-55, working and having no chronic disease at baseline of the Whitehall II study of London-based civil servants were selected (n=9040). We observed participants' exit from work through retirement, health-related exit and unemployment, new diagnosis of chronic disease (ie, coronary heart disease, diabetes, stroke and cancer) and their psychosocial working conditions in midlife. Using cause-specific Cox models, we examined the association of chronic disease and favourable psychosocial working conditions and their interaction, with the three types of work exit. We adjusted for gender, occupational grade, educational level, remaining in civil service, spouse's employment status and mental health.

RESULTS: Chronic disease significantly increased the risk of any type of work exit (HR 1.27) and specifically the risk of health-related exit (HR 2.42). High skill discretion in midlife reduced the risk of any type of work exit (HR 0.90), retirement (HR 0.91) and health-related exit (HR 0.68). High work social support in midlife decreased the risk of health-related exit (HR 0.79) and unemployment (HR 0.71). Favourable psychosocial working conditions in midlife did not attenuate the association between chronic disease and work exit significantly.

CONCLUSIONS: The chronically ill have increased risks of work exit, especially through health-related exit routes. Chronic disease is an obstacle to extended working lives. Favourable working conditions directly relate to reduced risks of work exit.

Original language	English
Pages (from-to)	183-190
Journal	Occupational and Environmental Medicine
Volume	75
Issue number	3
Early online date	17 Oct 2017
DOIs	https://doi.org/10.1136/oemed-2017-104452
Publication status	Published - Mar 2018

Keywords

chronic disease
psychosocial working conditions
retirement
older workers
work exit

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1136/oemed-2017-104452

Can favourable psychosocial working_FLEISCHMANN_Publishedonline17October2017_GOLD VoR (CC BY)Final published version, 236 KBLicence: CC BY

Cite this

@article{5b153eb9a6c246edb739b3ca7e630a8c,

title = "Can favourable psychosocial working conditions in midlife moderate the risk of work exit for chronically ill workers?: A 20-year follow-up of the Whitehall II study",

abstract = "OBJECTIVES: To investigate if favourable psychosocial working conditions can reduce the risk of work exit and specifically for workers with chronic disease.METHODS: Men and women (32%) aged 35-55, working and having no chronic disease at baseline of the Whitehall II study of London-based civil servants were selected (n=9040). We observed participants' exit from work through retirement, health-related exit and unemployment, new diagnosis of chronic disease (ie, coronary heart disease, diabetes, stroke and cancer) and their psychosocial working conditions in midlife. Using cause-specific Cox models, we examined the association of chronic disease and favourable psychosocial working conditions and their interaction, with the three types of work exit. We adjusted for gender, occupational grade, educational level, remaining in civil service, spouse's employment status and mental health.RESULTS: Chronic disease significantly increased the risk of any type of work exit (HR 1.27) and specifically the risk of health-related exit (HR 2.42). High skill discretion in midlife reduced the risk of any type of work exit (HR 0.90), retirement (HR 0.91) and health-related exit (HR 0.68). High work social support in midlife decreased the risk of health-related exit (HR 0.79) and unemployment (HR 0.71). Favourable psychosocial working conditions in midlife did not attenuate the association between chronic disease and work exit significantly.CONCLUSIONS: The chronically ill have increased risks of work exit, especially through health-related exit routes. Chronic disease is an obstacle to extended working lives. Favourable working conditions directly relate to reduced risks of work exit.",

keywords = "chronic disease, psychosocial working conditions, retirement, older workers, work exit",

author = "Maria Fleischmann and Ewan Carr and Stansfeld, {Stephen A.} and Baowen Xue and Jenny Head",

note = "{\textcopyright} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.",

year = "2018",

month = mar,

doi = "10.1136/oemed-2017-104452",

language = "English",

volume = "75",

pages = "183--190",

journal = "Occupational and Environmental Medicine",

issn = "1351-0711",

publisher = "BMJ Publishing Group",

number = "3",

}

Can favourable psychosocial working conditions in midlife moderate the risk of work exit for chronically ill workers? A 20-year follow-up of the Whitehall II study. / Fleischmann, Maria; Carr, Ewan; Stansfeld, Stephen A. et al.
In: Occupational and Environmental Medicine, Vol. 75, No. 3, 03.2018, p. 183-190.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Can favourable psychosocial working conditions in midlife moderate the risk of work exit for chronically ill workers?

T2 - A 20-year follow-up of the Whitehall II study

AU - Fleischmann, Maria

AU - Carr, Ewan

AU - Stansfeld, Stephen A.

AU - Xue, Baowen

AU - Head, Jenny

PY - 2018/3

Y1 - 2018/3

N2 - OBJECTIVES: To investigate if favourable psychosocial working conditions can reduce the risk of work exit and specifically for workers with chronic disease.METHODS: Men and women (32%) aged 35-55, working and having no chronic disease at baseline of the Whitehall II study of London-based civil servants were selected (n=9040). We observed participants' exit from work through retirement, health-related exit and unemployment, new diagnosis of chronic disease (ie, coronary heart disease, diabetes, stroke and cancer) and their psychosocial working conditions in midlife. Using cause-specific Cox models, we examined the association of chronic disease and favourable psychosocial working conditions and their interaction, with the three types of work exit. We adjusted for gender, occupational grade, educational level, remaining in civil service, spouse's employment status and mental health.RESULTS: Chronic disease significantly increased the risk of any type of work exit (HR 1.27) and specifically the risk of health-related exit (HR 2.42). High skill discretion in midlife reduced the risk of any type of work exit (HR 0.90), retirement (HR 0.91) and health-related exit (HR 0.68). High work social support in midlife decreased the risk of health-related exit (HR 0.79) and unemployment (HR 0.71). Favourable psychosocial working conditions in midlife did not attenuate the association between chronic disease and work exit significantly.CONCLUSIONS: The chronically ill have increased risks of work exit, especially through health-related exit routes. Chronic disease is an obstacle to extended working lives. Favourable working conditions directly relate to reduced risks of work exit.

AB - OBJECTIVES: To investigate if favourable psychosocial working conditions can reduce the risk of work exit and specifically for workers with chronic disease.METHODS: Men and women (32%) aged 35-55, working and having no chronic disease at baseline of the Whitehall II study of London-based civil servants were selected (n=9040). We observed participants' exit from work through retirement, health-related exit and unemployment, new diagnosis of chronic disease (ie, coronary heart disease, diabetes, stroke and cancer) and their psychosocial working conditions in midlife. Using cause-specific Cox models, we examined the association of chronic disease and favourable psychosocial working conditions and their interaction, with the three types of work exit. We adjusted for gender, occupational grade, educational level, remaining in civil service, spouse's employment status and mental health.RESULTS: Chronic disease significantly increased the risk of any type of work exit (HR 1.27) and specifically the risk of health-related exit (HR 2.42). High skill discretion in midlife reduced the risk of any type of work exit (HR 0.90), retirement (HR 0.91) and health-related exit (HR 0.68). High work social support in midlife decreased the risk of health-related exit (HR 0.79) and unemployment (HR 0.71). Favourable psychosocial working conditions in midlife did not attenuate the association between chronic disease and work exit significantly.CONCLUSIONS: The chronically ill have increased risks of work exit, especially through health-related exit routes. Chronic disease is an obstacle to extended working lives. Favourable working conditions directly relate to reduced risks of work exit.

KW - chronic disease

KW - psychosocial working conditions

KW - retirement

KW - older workers

KW - work exit

U2 - 10.1136/oemed-2017-104452

DO - 10.1136/oemed-2017-104452

M3 - Article

C2 - 29042407

SN - 1351-0711

VL - 75

SP - 183

EP - 190

JO - Occupational and Environmental Medicine

JF - Occupational and Environmental Medicine

IS - 3

ER -