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1.
Scand J Work Environ Health ; 50(4): 290-299, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38573826

RESUMO

OBJECTIVE: The aim of the study was to investigate the longitudinal association between multi-dimensionally measured precarious employment (PE) trajectories and mental health among older employees in Germany. METHODS: Current data from the German lidA study was used, including panel cases, who participated in all four survey waves (2011, 2014, 2018, 2022). The study comprised 1636 subjects, aged 46 and 52 years at baseline. Group-based trajectory modelling was used to model PE trajectories based on a score combining multiple items from the dimensions employment insecurity and income inadequacy. The association between PE trajectories (2011-2022) and mental health (2022) was tested using weighted logistic regression. RESULTS: We identified a PE trajectory with upward movement that best described 13.6% of the study sample. Representation in this group was socially unequally distributed with noticeably larger shares of female, lower-educated and lower-skilled workers in PE. Women following this trajectory had increased odds [odds ratio (OR) 1.68-1.82] of reporting poor mental health in 2022 compared to their counterparts in constant non-PE. This was not the case for men (OR 0.37-0.51). CONCLUSIONS: Our findings highlight horizontal and vertical inequalities with respect to exposure to and consequences of PE. Future labor market reforms should improve protection of women, who will likely be disadvantaged by accumulating employment-related mental health risks over the course of their lives.


Assuntos
Emprego , Saúde Mental , Humanos , Feminino , Alemanha/epidemiologia , Masculino , Pessoa de Meia-Idade , Emprego/estatística & dados numéricos , Saúde Mental/estatística & dados numéricos , Fatores Socioeconômicos , Estudos Longitudinais , Inquéritos e Questionários , Segurança do Emprego
2.
Sci Data ; 10(1): 868, 2023 12 05.
Artigo em Inglês | MEDLINE | ID: mdl-38052810

RESUMO

Metadata from epidemiological studies, including chronic disease outcome metadata (CDOM), are important to be findable to allow interpretability and reusability. We propose a comprehensive metadata schema and used it to assess public availability and findability of CDOM from German population-based observational studies participating in the consortium National Research Data Infrastructure for Personal Health Data (NFDI4Health). Additionally, principal investigators from the included studies completed a checklist evaluating consistency with FAIR principles (Findability, Accessibility, Interoperability, Reusability) within their studies. Overall, six of sixteen studies had complete publicly available CDOM. The most frequent CDOM source was scientific publications and the most frequently missing metadata were availability of codes of the International Classification of Diseases, Tenth Revision (ICD-10). Principal investigators' main perceived barriers for consistency with FAIR principles were limited human and financial resources. Our results reveal that CDOM from German population-based studies have incomplete availability and limited findability. There is a need to make CDOM publicly available in searchable platforms or metadata catalogues to improve their FAIRness, which requires human and financial resources.


Assuntos
Doença Crônica , Humanos , Metadados , Publicações
3.
PLoS One ; 18(8): e0285319, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37556415

RESUMO

OBJECTIVES: The objective of the study was to investigate the contribution of work factors and health-related lifestyle to educational inequalities in physical health among older workers in Germany by applying causal mediation analysis with longitudinal data. METHODS: Data from the German lidA study was used. 2653 persons (53% female, 47% male) aged 46 (born 1965) and 52 (born 1959) at baseline were followed up for seven years with exposure and outcome assessments in 2011 (t0), 2014 (t1) and 2018 (t2). The total effect of education on physical health was decomposed into a natural direct effect (NDE) and a natural indirect effect (NIE) by using a sex-stratified causal mediation analysis with an inverse odds weighting approach. Baseline health, partner status and working hours were entered as a first set of mediators preceding the putative mediators of interest. All analyses were adjusted for age and migrant status. RESULTS: Independent of the first set of mediators, work factors explained 21% of educational inequalities in physical health between low and high educated women and 0% comparing moderate versus high educated women. The addition of health behaviors explained further 26% (low vs. high education) and 20% (moderate vs. high education), respectively. Among men, net of the first set of mediators, work factors explained 5% of educational inequalities in physical health between low and high educated and 6% comparing moderate versus high educated persons. Additional 24% (low vs. high education) and 27% (moderate vs. high education) were explained by adding health behaviors to the models. CONCLUSIONS: To reduce educational inequalities in physical health among older workers in Germany, interventions to promote healthy behaviors are promising. Improving working conditions is likely an important prerequisite.


Assuntos
Estilo de Vida , Análise de Mediação , Humanos , Masculino , Feminino , Estudos de Coortes , Escolaridade , Alemanha , Fatores Socioeconômicos
4.
Gesundheitswesen ; 85(6): 514-521, 2023 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-36195109

RESUMO

OBJECTIVE: The aim of the study was to compare the employment perspective of older employees in different occupations in the health care sector. A distinction is made between three aspects of the employment perspective: until what age older employees want to, can and plan to work. METHODS: The data are based on the second (2014) and third (2018) wave of the representative lidA study, which surveyed employees born in 1959 and 1965, at intervals of 3 to 4 years since 2011. In descriptive cross-sectional and longitudinal analyses, five occupational groups of the health care sector were compared to further selected occupational groups (NSample=2.580). RESULTS: The occupational groups examined differed significantly in terms of their employment perspective. Employees in care professions stood out as, on average, they wanted to leave working life early, but most importantly, they could not work for as long as they had planned to. Longitudinal analyses indicated that the employment perspective shifted to higher age as the individuals approached the legal retirement age. CONCLUSIONS: Care professions are risk groups with regard to employment at higher working age and require special attention in health care organisations. The results also document substantial variability of employment perspective in individual employees over time. This finding has implications regarding opportunities for human resource management.


Assuntos
Emprego , Setor de Assistência à Saúde , Humanos , Pessoa de Meia-Idade , Estudos Transversais , Alemanha/epidemiologia , Aposentadoria
5.
Eur J Ageing ; 19(4): 1631-1637, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36506668

RESUMO

The way in which retirement is conceptualized and measured is likely to influence the research findings. The previous literature has addressed a wide range of elements related to the complex work-to-retirement process, such as early, late and partial retirement, statutory retirement, work disability and unemployment paths to retirement, or different types of bridge employment. However, conceptual clarity in terms of connections between the different elements is called for. We introduce a conceptual framework of the work-to-retirement process to guide its future measurement. Together with information on the statutory retirement age, the main elements of the framework are based on employment and pension receipt, acknowledging that these may overlap. The framework is flexible to the user, providing the possibility to add various specifications-e.g. of types of employment, types of pension receipt, unemployment, and being outside the labour force-depending on the study context and aims. The framework highlights the complexity of the work-to-retirement process, bringing forth its multifaceted, multiphased and multidirectional features. Accounting for such complexity in later-life labour market dynamics helps to elaborate what is actually addressed when investigating "retirement". Our conceptual framework can be utilized to enhance well-defined, precise and comparable measurement of the work-to-retirement process in studies.

6.
Scand J Work Environ Health ; 48(7): 569-578, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35708627

RESUMO

OBJECTIVE: The aim of this study was to investigate the contribution of work factors, health, and work ability to social inequalities in early exit from employment among older employees in Germany. METHODS: Longitudinal data from the representative German lidA Cohort study was linked with employment register data to obtain maximum information on exit routes out of paid employment. Information of N=2438 respondents, aged 46 and 52 at baseline, were obtained for a follow-up of six years (2011-2017). Causal mediation analysis with inverse odds weighting was conducted using discrete-time survival outcomes and baseline measurements of the socioeconomic status (SES: education), work factors, health, and work ability. RESULTS: Older employees with low SES were at an increased risk of exiting employment early by receiving disability pension and through long-term unemployment but not through an unspecified labor market exit when compared to those with high and moderate SES. Low work ability accounted for up to 38% of the social inequalities in work exits into disability pension. Less-than-good physical health accounted for up to 59% of inequalities in work exits into long-term unemployment. Work factors contributed considerably to inequalities in exits through unemployment but not disability pension. CONCLUSIONS: This study finds social inequalities in early exits through disability pension and long-term unemployment among older employees in Germany, predominantly attributable to differences in work ability (disability pension) and physical health (unemployment). Investments in work ability and promotion of physical health may constitute promising approaches to counteract an increase of these inequalities.


Assuntos
Análise de Mediação , Aposentadoria , Estudos de Coortes , Emprego , Alemanha , Humanos , Pensões , Fatores Socioeconômicos , Desemprego , Avaliação da Capacidade de Trabalho
7.
Scand J Work Environ Health ; 48(4): 312-321, 2022 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-35239972

RESUMO

OBJECTIVES: The aim of this discussion paper is to (i) identify the differentiated roles of health in the work-retirement transition, and, with respect to these, (ii) highlight topics related to conceptual and methodological problems and challenges in research, and (iii) present avenues for future research. METHODS: This discussion paper summarizes an OMEGA-NET working group discussion ongoing from November 2018 to September 2021 with face-to-face and online meetings as well as a written online discourse. RESULTS: 'Health' and 'retirement' are ambiguous concepts. With respect to both, in retirement research, the choice of concept and indicator influences the findings. In addition, the impact of health on retirement is not necessarily a direct one, but can be influenced by further factors such as the ability, motivation and opportunity to work. The strong overall association of poor health with retiring early (path 1) bears the risk of masking distinct and deviating mechanisms in subgroups. In fact, there is evidence that also good health may lead to early retirement (path 2), while both poor health (path 3) and good health (path 4) may also make people retire later. CONCLUSIONS: An increased awareness of the differentiated roles that health may have in the work-retirement transition as outlined in this discussion paper may support research to address questions relevant for policy and practice and increase the impact of research. Recommendations for occupational health and social research are given.


Assuntos
Saúde Ocupacional , Aposentadoria , Humanos , Estudos Longitudinais , Motivação
8.
Int Arch Occup Environ Health ; 94(1): 85-93, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32893311

RESUMO

OBJECTIVE: The aim of this prospective study was to examine employer changes among older workers and to relate them to psychosocial work factors, health, and work ability. Four groups of employees as elaborated by Hom et al. (2012) were distinguished: Enthusiastic leavers (EL), reluctant leavers (RL), enthusiastic stayers (ES), and reluctant stayers (RS). METHODS: Repeated Measures ANOVA analyses were based on data from the second and third waves (2014, 2018) of the German lidA Cohort Study, a representative study of employees born in 1959 or 1965. RESULTS: The largest proportion of participants was ES (73.3%), 13.2% stayed with their employer although they would have preferred to leave (RS). 7.1% changed employer between 2014 and 2018 voluntarily (EL), 6.4% involuntarily (RL). Analyses confirmed that the four groups already differed in 2014 in terms of health, work ability, and psychosocial work factors and that these outcomes change in different characteristic patterns over time. Most outcomes improved substantially following the change among EL. RS already reported poor outcomes in 2014 and exhibited a further deterioration while staying at the undesired workplace. CONCLUSION: Our findings indicate that an employer change is followed by improvements of work, health, and work ability. We conclude that an inclusive labor market policy for older workers allowing for high job mobility may have the potential to contribute to considerable improvements of workers' individual working conditions, health, and work ability, thereby increasing the work participation. Also, the considerable group of RL requires increased political and scientific attention.


Assuntos
Envelhecimento/psicologia , Mobilidade Ocupacional , Local de Trabalho/psicologia , Estudos de Coortes , Feminino , Alemanha , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade
9.
Int Arch Occup Environ Health ; 94(3): 377-390, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33084928

RESUMO

PURPOSE: Older employees are often thought to be vulnerable to negative effects of information and communication technology (ICT). Our study aims to examine associations between work-related ICT exposure (i.e. ICT use or digital work intensification), physical health, mental health and work ability (WA). We examine whether these associations are modified by socio-economic position (SEP). METHODS: We analysed cross-sectional data from 3180 participants (born in 1959 and 1965) in wave 3 of the representative German lidA cohort study. We performed hierarchical multiple regression to assess the distinct associations of ICT use and digital work intensification with mental and physical health and WA. We stratified analyses by SEP and controlled for age, sex, and digital affinity. RESULTS: 92% of participants reported ICT use at work. Almost 20% reported high levels of digital work intensification, while a similar proportion did not experience digital work intensification. In bivariate analyses, ICT use by itself was not significantly associated with mental health or WA in the total sample or when stratified. Digital work intensification displayed negative associations with mental health and WA. In hierarchical multiple regressions, digital work intensification showed consistently negative associations with mental health and work ability of similar strength across SEP. CONCLUSION: Our results suggest that ICT use, per se, does not negatively impact older workers. Digital work intensification may be associated with worse mental health and work ability. Research on health and social implications of work-related ICT should differentiate patterns of ICT exposure and assess modifications by SEP to better gauge the ambiguous effects of ICT.


Assuntos
Envelhecimento/psicologia , Comunicação , Tecnologia Digital , Nível de Saúde , Tecnologia da Informação , Saúde Mental , Telefone Celular , Estudos de Coortes , Computadores , Correio Eletrônico , Feminino , Alemanha , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Autorrelato , Fatores Socioeconômicos , Avaliação da Capacidade de Trabalho , Local de Trabalho/psicologia
10.
Int Arch Occup Environ Health ; 94(2): 295-307, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32897436

RESUMO

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.


Assuntos
Depressão/epidemiologia , Avaliação da Capacidade de Trabalho , Local de Trabalho/psicologia , Fatores Etários , Estudos de Coortes , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Apoio Social
11.
J Occup Environ Med ; 63(1): e1-e6, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33149006

RESUMO

OBJECTIVE: Supporting employees with health impairments to stay at work through workplace accommodation is a well-researched topic. However, research on workplace accommodations for older employees is lacking. METHODS: Cross-sectional data from the German lidA cohort study in 2018 focusing on older employees who reported poor health (n = 421) was analyzed. A multiple logistic regression analysis was conducted to asses a potential association between the accommodation type and perceived helpfulness of workplace accommodations in older employees with poor health. RESULTS: Changes in working times (OR 6.59), in work tasks (OR 3.50) and in the workplace (OR 2.57) were perceived as most helpful. CONCLUSION: The results indicate that workplace accommodations can be helpful in older employees with health impairments and that this is not by chance, but that the perceived effectiveness has determinants and can be influenced.


Assuntos
Avaliação da Capacidade de Trabalho , Local de Trabalho , Idoso , Estudos de Coortes , Estudos Transversais , Alemanha , Humanos
12.
Rehabilitation (Stuttg) ; 60(1): 11-20, 2021 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-33152776

RESUMO

INTRODUCTION: Rehabilitation services are considerably less used by persons with a migration background of working age in Germany than by persons without migration background. One reason could be access barriers. They can arise both from the structures of the health/rehabilitation system as well as from influences of the personal environment, e. g. financial burdens incurred through the use of rehabilitation or cultural expectations. In addition to the migration status, other factors such as country of origin, reasons for immigration, length of stay as well as the religious affiliation and social status could influence the utilization of medical rehabilitation. It was examined to what extent differences in utilisation are due to the migration background and to migration-independent personal barriers to access. METHODS: The lidA-study is a nationwide, representative prospective cohort study among employees with insurable employment born in 1959 and 1965 with a focus on work, age, health and employment. Data from the first (2011) and the second wave (2014) were combined for the analyses. In addition to bivariate analyses to describe the sample according to migration status, logistic regression analyses were carried out to estimate the odds ratios for the influence of migration background or nationality and other factors on the use of a medical rehabilitation measure. RESULTS: The chance of receiving medical rehabilitation is increased for migrants of the 1st generation (odds ratio (OR) 1.56, 95% confidence interval (CI): 1.09-2.25). If predominantly or exclusively no German is spoken at home, this could be associated with a comparatively much lower chance of utilisation (OR: 0.56, 95% CI: 0.28-1.15). Because only nationality is often available in routine data to determine the status of migration, another model only considers migrants and 2nd generation nationals and examines the influence of nationality on utilisation. A foreign nationality was not associated with a higher utilisation (OR: 1.07, 95% CI: 0.55-2.08). DISCUSSION: Results of previous studies on the use of medical rehabilitation for people with a migration background are inconsistent. This could be due to different examined population groups, different indications for rehabilitation, a temporal change in utilisation and the various study designs as well as data sources. We found a higher use of medical rehabilitation services by persons with a migrant background (1st generation) compared to non-migrant persons. One reason could be our more precise definition of the migration background compared to analyses of routine data. If predominantly or exclusively another language than German is spoken at home, the utilisation tends to be lower. The finding coincides with a lack of German language skills described as an access barrier in the literature.


Assuntos
Emigração e Imigração/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Centros de Reabilitação/estatística & dados numéricos , Reabilitação/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Estudos de Coortes , Emprego , Alemanha , Humanos , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Estudos Prospectivos , Fatores Socioeconômicos
13.
J Occup Health ; 62(1): e12166, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32906224

RESUMO

OBJECTIVES: The aim of this study was to investigate the subjective employment perspective in higher working age for different employee groups with migrant background (EMB) and without (non-EMB), meaning willing, being able, and planning to work until the individual state pension age (iSPA). METHODS: A representative sample of socially insured employees born in 1959 or 1965 was surveyed in 2011, 2014, and 2018 with computer-assisted personal interviews. The current cross-sectional analysis is based on data from the third study wave (n = 3286) of the lidA cohort study. EMB were differentiated via generation (first generation, G1, vs second generation, G2) or nationality (German vs foreign). Applying bivariate statistics with the tests of independence and block-wise logistic regressions, group differences were investigated. Sex, age, educational level, net household income, health, and work factors were considered as covariates. RESULTS: When comparing subgroups of EMB, significant differences appeared in bivariate analyses for willing and planning to work. G1 were to a higher degree planning to work longer than G2 and those with foreign nationality were more willing and planning than those with German nationality. Multivariate analyses revealed significant differences of G1 and non-EMB for planning, being significant in the fully adjusted model, but not for willing. CONCLUSION: The findings underline the need for differentiation of migrant groups in social research and policy. When it comes to extended working lives, the first-generation migrant group, as well as foreigners may constitute risk groups and require increased attention from a work, health, and economic point of view.


Assuntos
Emprego , Motivação , Aposentadoria , Migrantes , Engajamento no Trabalho , Estudos Transversais , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade
14.
BMC Public Health ; 20(1): 1452, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32977775

RESUMO

BACKGROUND: This study investigates whether a typology of work exposure can be established among older workers in Germany. Work exposure comprises physical work, working time quality, work intensity, skills & discretion, social environment, leadership, continued education, earnings and work prospects. METHODS: Latent profile analysis was conducted on a representative sample of the socially insured workforce in Germany born in 1959 or 1965 (N = 6277). Seven year-prospective associations between the typology and work-related outcomes (physical and mental health, work ability and work-privacy-conflict) were investigated to establish the distinctness of the profiles. RESULTS: Five profiles were identified: "Poor Quality" (19%), "Relaxed Manuals" (30%), "Strained non-Manuals" (16%), "Smooth Running" (33%) and "High Flying" (3%). These profiles exhibited diverging patterns of association with the selected outcomes, thus representing qualitatively distinct subgroups of older workers in Germany. CONCLUSIONS: We conclude that a typological approach may broaden the understanding of the ageing work force and the complex interplay of the overall work situation with outcomes of high individual and social relevance such as health, work ability and employment. The five work profiles identified in this study may constitute crucial clusters needed to reliably mirror today's over-all work exposure patterns in the older work force in Germany. They may allow for the comprehensible monitoring of quality of work and personal life among the older work force during their last working years and their transition to retirement in current times of extending working lives.


Assuntos
Emprego , Aposentadoria , Estudos de Coortes , Alemanha/epidemiologia , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos
15.
J Occup Health ; 62(1): e12130, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32515884

RESUMO

INTRODUCTION: In times of extending working lives, it is relevant to understand why, today, most workers leave employment long before regular retirement age. Financial factors have been central for explaining retirement timing, yet their impact seems rather complicated. This study explores the motivation to keep working, in relation to the economic household conditions among older workers and it investigates the impact of socio-demographic, individual and work factors on the motivation to keep working (MTW), again differentiated by economic household condition. METHODS: Based on data from wave three (2018) of the lidA Cohort Study, a representative interview study of socially insured employees born in 1959 or 1965 in Germany, descriptives and linear regression analyses were performed among 2835 employed participants. For all analyses, the sample was divided into five household equivalized net income groups. RESULTS: The groups with low and second lowest income were most motivated to work longer, followed by those with the highest income. The lowest income group exhibited most adverse scores for work indicators and health. Furthermore, in this group, MTW was unrelated to physical and mental health indicating that the comparably high motivation may be driven by financial imperatives. DISCUSSION AND CONCLUSIONS: The findings indicate that many workers with low income may find themselves forced to extend their working life, irrespective of their health. This requires increased attention by research as well as policy. Policy might have to acknowledge group specific negative side effects of regulations effectively extending working lives.


Assuntos
Renda , Motivação , Aposentadoria/economia , Estudos de Coortes , Estudos Transversais , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Ocupações
16.
BMC Health Serv Res ; 20(1): 31, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31924217

RESUMO

BACKGROUND: An ageing and a shrinking labour force implies that the prevention of a premature exit from work due to poor health will become more relevant in the future. Medical rehabilitation is a health service that aims at active participation in working life. The provision of this service will be relevant for an increasing part of the ageing labour force, namely, employees with a migrant background and their different subgroups. Thus, this study examines whether first- and second-generation employees with migrant background differ from non-migrants in their utilisation of rehabilitation services and whether within the subsample of migrant employees, those persons with foreign nationality differ from those with German nationality. METHODS: Socially insured employees born in 1959 or 1965 were surveyed nationwide in 2011 as part of the lidA cohort study (n=6303). Survey data of the first study wave were used to identify the dependent variable of the utilisation of rehabilitation (in- and outpatient), the independent variable of migrant status and the covariates of sociodemographic, work- and non-work-related factors. Applying bivariate statistics with tests of independence and block-wise logistic regressions, differences between the groups were investigated. Additionally, average marginal effects were computed to directly compare the adjusted models. RESULTS: The study showed that first-generation migrants had a significantly lower likelihood of utilising outpatient rehabilitation than non-migrants (fully adj. OR 0.42, 95% CI 0.22-0.82) and that average marginal effects indicated higher differences in the full model than in the null model. No significant differences were found between the first- or second-generation migrants and non-migrants when comparing the utilisation of inpatient rehabilitation or any rehabilitation or when analysing German and foreign employees with migrant background (n=1148). CONCLUSIONS: Significant differences in the utilisation of outpatient rehabilitation between first-generation migrants and non-migrants were found, which could not be explained by sociodemographic, work- and non-work-related factors. Thus, further factors might play a role. The second-generation migrants resemble the non-migrants rather than their parent generation (first-generation migrants). This detailed investigation shows the heterogeneity in the utilisation of health services such as medical rehabilitation, which is why service sensitive to diversity should be considered.


Assuntos
Utilização de Instalações e Serviços/estatística & dados numéricos , Reabilitação/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Estudos de Coortes , Emprego , Feminino , Alemanha , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , Pessoa de Meia-Idade
17.
Artigo em Inglês | MEDLINE | ID: mdl-31547466

RESUMO

Work ability (WA) is an important concept in occupational health research and for over 30 years assessed worldwide with the Work Ability Index (WAI). In recent years, criticism of the WAI is increasing and alternative instruments are presented. The authors postulate that theoretical and methodological issues need to be considered when developing alternative measures for WA and conclude that a short uni-dimensional measure is needed that avoids conceptual blurring. The aim of this contribution is to validate the short and uni-dimensional WAI components WAI 1 (one item measuring "current WA compared with the lifetime best") and WAI 2 (two items assessing "WA in relation to the [mental/physical] demands of the job"). Cross-sectional and 12-month follow-up data of two large samples was used to determine construct validity of WAI 1 and WAI 2 and to relate this to respective results with the WAI. Data sources comprise nurses in Europe investigated in the European NEXT-Study (Sample A; Ncross-sectional = 28,948 and NLongitudinal = 9462, respectively) and nursing home employees of the German 3Q-Study (Sample B) where nurses (N = 786; 339, respectively) and non-nursing workers (N = 443; 196, respectively) were included. Concurrent and predictive validity of WAI 1 and WAI 2 were assessed with self-rated general health, burnout and considerations leaving the profession. Spearman rank correlation (ρ) with bootstrapping was applied. In all instances, WAI 1 and WAI 2 correlated moderately, and to a similar degree, with the related constructs. Further, WAI 1 and 2 correlated with WAI moderately to strongly with ρ ranging from 0.72-0.76 (WAI 1) and 0.70-0.78 (WAI 2). Based on the findings and supported by theoretical and methodological considerations, the authors confirm the feasibility of the short measures WAI 1 and WAI 2 for replacing WAI at least in occupational health research and employee surveys.


Assuntos
Enfermeiras e Enfermeiros/psicologia , Saúde Ocupacional/estatística & dados numéricos , Avaliação da Capacidade de Trabalho , Adulto , Esgotamento Psicológico , Estudos Transversais , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ocupações
19.
Z Gerontol Geriatr ; 52(Suppl 1): 3-13, 2019 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-30280240

RESUMO

BACKGROUND: Over the course of the demographic transition with an aging and shrinking work force, work participation of older employees becomes more and more important. Earlier investigations found social groups to be different in work-related and individual aspects, which were shown to be associated with motivation for early retirement. OBJECTIVE: The aim of the study was to investigate the differences between older employees from distinct social groups in the motivation and determinants for early retirement. MATERIAL AND METHODS: Within the framework of the prospective lidA cohort study ( www.lida-studie.de ) socially insured employees born in 1959 and 1965 were asked about work, health and work participation. Based on data from the 3961 participants who were employed at the time of both study waves (2011, 2014), associations between variables of horizontal (gender, migration background) and vertical (education) social inequality and motivation for early retirement were analyzed with multiple logistic regression and interaction analysis. RESULTS: There was an educational gradient regarding the motivation to retire in the expected direction. The wish to retire before the age of 65 years was less common in male than in female older employees. Employees with a lower level of education and with a first generation migration background wished to retire early significantly less frequently than those without a migration background. Besides the interaction between migration background and education there were no further significant moderating effects of work-related or non-work-related variables on the association of social variables and the wish to retire early. CONCLUSION: According to the results there are differences between social groups of older employees in the motivation to retire early. The reasons and the final realization still have to be investigated. As a result, consequences for companies and politics with respect to the preservation of the work force can arise.


Assuntos
Motivação , Aposentadoria , Estudos de Coortes , Emprego , Feminino , Alemanha , Humanos , Masculino , Estudos Prospectivos , Aposentadoria/psicologia
20.
Scand J Work Environ Health ; 43(5): 465-474, 2017 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-28553992

RESUMO

Objectives Few epidemiological studies have examined whether associations of psychosocial working conditions with risk of poor health differ by age. Based on results from mostly cross-sectional studies, we test whether (i) psychosocial relational factors (social support) are more strongly associated with declining health of older than younger employees and (ii) psychosocial job factors (workpace, influence, possibilities for development) are more strongly associated with declining health of younger than older employees. Methods We extracted two cohorts from the Danish Work Environment Cohort Study (DWECS): the 2000-2005 and 2005-2010 cohorts. The participating 5281 employees with good self-rated health (SRH) at baseline were observed in 6585 5-year time windows. Using log-binomial regression analyses, we analysed whether psychosocial factors at work predicted 5-year deterioration of SRH. Effect modification by age was estimated by calculating relative excess risk due to interaction (RERI). Results High workpace among men, low influence at work as well as low social support from colleagues among women, and low possibilities for development and low social support from supervisors among both genders predicted 5-year decline in SRH. Of the 20 interaction analyses, only 1 was statistically significant and in the opposite direction of what was hypothesized (higher risk for declining SRH among middle-aged men with low possibilities for development compared to the young men with high possibilities for development). Conclusions Psychosocial working conditions predicted decline in SRH in this 5-year follow-up study. The model did not support our hypotheses about modifying effects by age.


Assuntos
Envelhecimento/psicologia , Autoavaliação Diagnóstica , Apoio Social , Local de Trabalho/psicologia , Adulto , Fatores Etários , Estudos de Coortes , Estudos Transversais , Dinamarca , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Estresse Psicológico/psicologia
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