WORKLONG – JTC2015

Short introduction (aim, goal of project, when did this project start?)

The Worklong project started in March 2016 and has 4 objectives in 5 Work Packages:

The first objective determines whether workers with health problems will spend the added years before retirement primarily in paid employment or in disability, unemployment, and early retirement. What is a worker’s ability to remain employed until retirement and how do social welfare systems influence labour force participation of older workers with health problems? (Work Package 1)

The second objective investigates the potential benefits of interventions on strenuous working conditions and on promoting healthier behaviours for a worker’s ability to remain employed and, thereby effectively reducing premature retirement. Also, the potential extension of working careers is estimated by implementing policies and provisions that support workers with health problems in paid employment. (Work Package 2)

The third objective analyses the consequences of retirement at older age for health and health disparities in the years before and after retirement. For whom will retirement (at later age) be beneficial, and for whom will it deteriorate health? (Work Package 3 & 4)

The fourth objective evaluates the costs, benefits and effectiveness of intervention and policies, basically answering the question which investments for whom are advisable to support older workers until statutory retirement age. (Work Package 5)

What kind of impact on the society is expected?

The premier target population are older workers, who have a chronic health problem that may affect their ability to enter and maintain paid employment throughout their work career. It is estimated that within the European Union approximately 25% of workers suffer from a longstanding problem which restricts their daily activities, i.e. about 30 million in the European Union. The main causes of longstanding health problems in the working age population are chronic diseases, such as musculoskeletal diseases, cardiovascular diseases, respiratory diseases, and mental, nervous or emotional problems. The European Pact for Mental Health and Well-being has estimated that up to 10% of the European population will experience some type of depressive or anxiety related disorder every year, with women much more at risk than men. The estimated annual costs of depression in the 15 workforce in the European Economic Area were approximately €100 billion due to productivity losses from employment. For other comparable diseases cost of illness studies have been published. These figures demonstrate that the target population is large and that the social and economic consequences of chronic disease are of paramount importance to the health and wealth of the working population.

Our research contributes directly to current and evolving governmental policies on employment and retirement by providing sound evidence for impact on length of employment and health. We will use stakeholders’ views how results of the project can be best summarized, presented and disseminated via stakeholders’ channels of communication. We anticipate that a variety of methods will be applied, such as downloadable fact sheets, policy letters, press releases, and social media.

Which phase of your project are you at the moment? 

Work package 1 The impact of legislation and policy measures on pathways to retirement among workers with health problems

Data from the European Union Statistics on Income and Living Conditions (EU-SILC) are used to analyze educational inequalities in a) the influence of a chronic illness on labour force participation and b) the contribution of poor health to different pathways out of paid employment. Differences between European regions and trends of labour force participation between 2005 and 2014 are analyzed. In addition, the effect of national social and economic indicators on the association between poor health and labour force exit through different pathways in 25 European countries is analysed. Finally, the Dutch-EU-SILC data (2004-2015) are used to analyze the effect of changes in early retirement schemes on labour force participation among persons with health problems in the Netherlands

Data from a cohort of construction workers are used to analyze the impact of changes in welfare legislation on the incidence of disability pension in Sweden. The cohort has a follow-up period of 40 years. Data from this cohort is used to analyse how changes (restrictions) in disability benefits affect labour force participation in Sweden.

Expected output: at least 4 papers, of which 2 are submitted in 2017. The Impact Advisory group will be asked for advice on policy implications of the results.

Work package 2 Influence of workplace and lifestyle interventions and policies on employment trajectories

A multistate Markov model is being developed to estimate working life expectancy, which captures the total working years expected for specific groups of workers. The next step of modelling will be to estimate working years lost due to strenuous working conditions and unhealthy behaviours and to predict the potential effects of workplace and health behaviour interventions as well as policy measures on working life expectancy.  The current status is that we have finally addressed the computational problems of working with large datasets (> 1 million persons with monthly information over period of 3 years). The first preliminary results of the Markov model are now under consideration by Statistics Netherlands for approval of output use.

Work package 3 Impact of legislation and policy measures on the health of workers from different social groups before and after retirement.

Data from Understanding Society from the UK are used to investigate the effect of the policy to postpone retirement age from 60 to 65 on health among women. In this study, mental and physical health (SF12) as well as psychological status (GHQ-12) are measured among women aged 60-64 years in six waves between 2009 and 2015. In addition, information about employment status and job type as well as biomarkers is available. Current status: first paper to be submitted within few weeks. Two other papers are discussed in November 2017 meeting and will be submitted thereafter.

Work package 4 Impact of timing of exit from labour market on morbidity and mortality

Data from the Swedish cohort of construction workers have been linked with registry data to analyse mortality risks in disability pensioners with common mental disorder in Sweden. Preliminary analysis have been conducted. We are starting analysing how chronic diseases and work factors influence the exit through disability pension and possibilities to paid work when the possibilities for disability pension is strongly restricted. We are also studying whether change of job/industry improve/decrease the work participation.

Work package 5 Cost-effectiveness of successful policies and interventions

We will start with the cost-effectiveness analysis in 2018.

Did  you already get any preliminary results?

Submitted/final draft papers

  • Educational inequalities in the influence of a chronic illness on employment across five European regions (2005-2014)
  • Educational inequalities in the contribution of poor health to different pathways out of paid employment in five European regions
  • Health-effects of higher State Pension Age in UK
  • Impact of changes in welfare legislation on the incidence of disability pension. A cohort study of construction workers.
  • Mortality risks in disability pensioners with common mental disorder in Sweden

Could you summarize these results?

Educational inequalities in the influence of a chronic illness on employment across five European regions (2005-2014)

Person with a chronic illness have much lower labour force participation than persons without illness. A chronic illness has a larger impact on labour force participation among low educated persons compared to higher educated persons. In the Northern, Anglo-Saxon and Eastern regions, the impact of a chronic disease on labour force participation were larger compared to the Southern and Continental regions.

Educational inequalities in the contribution of poor health to different pathways out of paid employment in five European regions

In descending order of magnitude, poor health was associated with loss of paid employment due to disability, unemployment, economic inactivity and retirement in all European regions. In most European regions, the influence of poor health on disability and retirement was more profound among high educated workers, whereas the influence of poor health on becoming economically inactive was more profound among low educated workers. However, due to the higher prevalence of poor health among low educated workers, the proportion of unemployment, disability, and economic inactivity that could be attributed to poor health was larger among low educated workers than high educated workers in most European regions. The largest educational inequalities in the proportion of exit from paid employment due to poor health were found in the Northern and Eastern regions and the smallest educational inequalities were found in the Southern region.

Health-effects of higher State Pension Age in UK

This study showed that a policy that postpone retirement age from 60 to 65 among women in the United Kingdom had a negative effect on health. In addition, increasing the length of the extension was associated with stronger effects on mental health.

Impact of changes in welfare legislation on the incidence of disability pension. A cohort study of construction workers.

Changes in legislation during the 1990s showed associations with a rather strong variability in musculoskeletal diagnosis especially in older ages, but not with psychiatric diseases. In addition to legislation, there are other actors in the disability pension granting process, such as the physicians and the insurance agency administrators.

Mortality risks in disability pensioners with common mental disorder in Sweden

In this study mortality in DP recipients with common mental disorder was compared to other DP diagnosis and to those without DP. The hypothesis was that relief from work should enhance survival in persons with DP based on common mental disorders. Subjects with DP based on a psychiatric diagnosis displayed higher mortality risks, which contradicts the study hypothesis. Leaving work implies both adding and reducing potential risk factors, making it difficult to elucidate total health effects

Are the results in line with your a priori expectation?

Educational inequalities in the influence of a health problems  on labour force participation and pathways out of employment across five European regions

The findings that there are educational differences in the effect of health problems on labour force participation  and labour force exit, is in accordance with findings from earlier studies. However, we did not expect to find that a poor health was a stronger predictor for labour force exit due to disability and retirement among higher educated workers compared to lower educated workers. Apparently, low educated workers with health problems are more likely to take other pathways out of paid employment, such as economic inactivity.

Overall, the gap in labour force participation between those with a chronic illness and those without is large and much larger than national unemployment rates, illustrating that most EU countries do not have effective policies to provide sustained access to paid employment for persons with a chronic disease.

Health-effects of higher State Pension Age in UK

We did not expect a negative health effect of postponing the retirement age from 60 to 65 among women in the UK. The results of this study show that postponing retirement age may have a negative effect on health. On the other hand, the emotional reaction to the reform on lower self-reported health may matter more at short-term than long-term consequences of the actual shift in retirement age.

Impact of changes in welfare legislation on the incidence of disability pension. A cohort study of construction workers.

We expected to find a strong temporal effect of changes in disability granting legislation on the incidence of disability pension granting. However, this was only found for musculoskeletal diagnosis,  but not for psychiatric diseases. We found that professionals who apply the legislation (physicians and the insurance agency administrators) have a major influence on the incidence of disability granting.

Mortality risks in disability pensioners with common mental disorder in Sweden

We expected that relief from work should enhance survival in persons with disability pension based on common mental disorders. However, the finding that subjects with disability pension based on a psychiatric diagnosis displayed higher mortality risks contradicts this hypothesis. Leaving work implies both adding and reducing potential risk factors, making it difficult to elucidate total health effects

Did your project receive some external feedback (from possible stakeholder, national journals, etc…)?

We have established an Impact Advisory Group, in which professionals of different organizations are involved (PEROSH, Netspar, Eurofound, OECD). We will sent a draft paper to the Impact Advisory Group and ask for their input concerning the interpretation of the results and its policy implications.

What are the phases planned for the immediate future? 

Work package 1 The impact of legislation and policy measures on pathways to retirement among workers with health problems

The effect of national social and economic indicators on the association between poor health and labour force exit through different pathways in 25 European countries will be analysed. In addition, the Dutch-EU-SILC data (2004-2015) will be used to analyze the effect of changes in early retirement schemes on labour force participation among persons with health problems in the Netherlands

Work package 2 Influence of workplace and lifestyle interventions and policies on employment trajectories

A model will be developed to estimate working years lost due to strenuous working conditions and unhealthy behaviours and to predict the potential effects of workplace and health behaviour interventions as well as policy measures on working life expectancy.

Work package 3 Impact of legislation and policy measures on the health of workers from different social groups before and after retirement

Data from Understanding Society from the UK will be used to investigate the effect of the policy to postpone retirement age from 60 to 65 on different health measures as well as biomarkers, such as C-reactive protein, among women in the UK. In addition, job-type health inequalities and higher state pension age will be investigated.

Work package 4 Impact of timing of exit from labour market on morbidity and mortality

Data from the Swedish cohort of construction workers will be used to analyse a) how changes (restrictions) in disability benefits affect labour force participation in Sweden depending on chronic diseases and type of job and b) the role of job mobility in relation to the length of working life in Sweden.

Work package 5 Cost-effectiveness of successful policies and interventions

We will start with the cost-effectiveness analysis in 2018.

Download the project’s brochure.

Download the project’s conference poster.

 

 

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