Staffing agency: A bridge to working during retirement.

BACKGROUND: The ageing population has initiated a debate about a prolonged working life. There is an interest in finding the pre-retirement predictors of bridge employment and retirement decisions, but the understanding of the experiences of bridge employees is still limited. OBJECTIVES: The aim was to describe the characteristics of the pensioners working for a staffing agency, their motivational aspects, work patterns and types of services they provided. METHODS: This article analyses the results from a Swedish staffing agency's yearly co-worker questionnaire from December 2017. The response rate was 44% (N = 1741). The design is descriptive, with correlation analyses and construction of typical cases. RESULTS: Most study participants were aged 65-74 years. Sixty-five percent were men, 66% were cohabitating/married, dominating education level was secondary school or higher education (79%). Important incentives for working were the social context and to gain extra income. A majority of the respondents also stated that their work increased their overall well-being. Seventy-eight percent worked 25 hours per month or less, 37% wanted to work more, 3% wanted to work less. Private services dominated with 61%; most common were gardening (43%), trades (33%) and cleaning (31%). CONCLUSIONS: More men than women chose this form of work. While single women need to work out of economic necessity, men, to a larger extent, work for the social context and well-being. The highest work frequency in 2017 (14%) in the population was found for those who retired in 2015, i.e. two years after their retirement year. A majority indicated that the work they were doing was different from earlier in their working life.

Mobile Geriatric Teams - A Cost-Effective Way Of Improving Patient Safety And Reducing Traditional Healthcare Utilization Among The Frail Elderly? A Randomized Controlled Trial.

BACKGROUND: Demographic changes combined with costly technological progress put a financial strain on the healthcare sector in the industrialized world. Hence, there is a constant need to develop new cost-effective treatment procedures in order to optimize the use of available resources. As a response, the concept of a Mobile Geriatric Team (MGT) has emerged not only nationally but also internationally during the last decade; however, scientific evaluation of this initiative has been very scarce. Thus, the objective of this study was to perform a mixed methods analysis, including a prospective, controlled and randomized quantitative evaluation, in combination with an interview-based qualitative assessment, to measure the effectiveness and user satisfaction of MGT. MATERIALS AND METHODS: Community-dwelling, frail elderly people were randomized to an intervention group (n=31, mean age 84) and a control group (n=31, mean age 86). A two-year retrospective quantitative data collection and a prospective one-year follow-up on healthcare utilization were combined with qualitative interviews. Non-parametric statistics and difference-in-difference (DiD) analyses were applied to the quantitative data. Qualitative data were analyzed using content analysis. RESULTS: No significant group differences in healthcare utilization were found before inclusion. Post intervention, primary care contact (including MGTs) increased for the MGT group. Inpatient care decreased dramatically for both groups. Hence, the increase in primary care contact for MGT patients was not accompanied by a reduction in inpatient care compared to the control group. Utilization of non-primary care was lower (p< 0.01) post-intervention in both groups. CONCLUSION: There appears to be a "natural" variation in healthcare needs over time among frail elderly people. Hence, it is vital to perform open, controlled clinical studies in tandem with the implementation of new caregiving strategies. The MGT initiative was clearly appreciated but did not fully achieve the desired reduction in healthcare utilization in this study. TRIAL REGISTRATION: Retrospectively registered 09/10/2018, ClinicalTrials.gov ID NCT03662945.

A scoping review of the incentives for a prolonged work life after pensionable age and the importance of "bridge employment".

BACKGROUND: With a growing share of older people in almost every population, discussions are being held worldwide about how to guarantee welfare in the immediate future. Different solutions are suggested, but in this article the focus is on the need to keep older employees active in the labor market for a prolonged time. OBJECTIVE: The aim was to find out and describe the incentives at three system levels for older people 1) wanting, 2) being able, and 3) being allowed to work. MATERIAL: The literature search embraced articles from the databases Scopus, PsycInfo, Cinahl, AgeLine and Business Source Premier, from May 2004 until May 2016. After the removal of 506 duplicates, the selection and analysis started with the 1331 articles that met the search criteria. Of these, 58 articles corresponded with the research questions. METHOD: The design was a 'scoping review' of the research area bridge employment and prolonged work life. RESULTS: The results show that most investigations are conducted on individual-level predictors, research on organizational-level predictors is more scattered, and societal-level predictor information is scarce. CONCLUSIONS: Attitudes and behavior according to a prolonged work life could be summarized as dependent on good health, a financial gain in combination with flexible alternative working conditions.

Blowing up money? The earnings penalty of smoking in the 1970s and the 21st century.

We analyze the earnings penalty of smoking among Swedish twins in two social contexts: the 1970s, when smoking was common and widely accepted and when there were relatively few tobacco laws aiming to reduce smoking; and the 2000s, when smoking had become more expensive, stigmatizing and less common, and when tobacco laws and regulations had intensified. The results show that the short-term earnings penalty of smoking was much higher in the 21st century than in the 1970s for men. For women, smokers had on average higher annual earnings compared to nonsmokers in the 1970s, but lower annual earnings in the 2000s. In the long run, there was an earnings gap for men between never-smokers and continuous smokers, whereas there was a pronounced earnings 'bonus' of smoking cessation for women. The results emphasize the importance of social context and the long-term horizon when evaluating the consequences of smoking for earnings.

Two by two, inch by inch: Height as an indicator of environmental conditions during childhood and its influence on earnings over the life cycle among twins.

Adult height is a function of genetic predispositions and environmental influences during childhood. Hence, any variation in height among monozygotic twins, who share genetic predispositions, is bound to reflect differences in their environmental exposure. Therefore, a height premium in earnings among monozygotic twins also reflects such exposure. In this study, we analyze the height premium over the life cycle among Swedish twins, 10,000 of whom are monozygotic. The premium is relatively constant over the life cycle, amounting to 5-6% higher earnings per decimeter for men and less for women, suggesting that environmental conditions in childhood and youth affect earnings over most of the adult life course. The premium is larger below median height for men and above median height for young women. The estimates are similar for monozygotic and dizygotic twins, indicating that environmentally and genetically induced height differences are similarly associated with earnings.

The Effect of Schooling on Mortality: New Evidence From 50,000 Swedish Twins.

By using historical data on about 50,000 twins born in Sweden during 1886-1958, we demonstrate a positive and statistically significant relationship between years of schooling and longevity. This relation remains almost unchanged when exploiting a twin fixed-effects design to control for the influence of genetics and shared family background. This result is robust to controlling for within-twin-pair differences in early-life health and cognitive ability, as proxied by birth weight and height, as well as to restricting the sample to MZ twins. The relationship is fairly constant over time but becomes weaker with age. Literally, our results suggest that compared with low levels of schooling (less than 10 years), high levels of schooling (at least 13 years of schooling) are associated with about three years longer life expectancy at age 60 for the considered birth cohorts. The real societal value of schooling may hence extend beyond pure labor market and economic growth returns. From a policy perspective, schooling may therefore be a vehicle for improving longevity and health, as well as equality along these dimensions.

Body size, skills, and income: evidence from 150,000 teenage siblings.

We provide new evidence on the long-run labor market penalty of teenage overweight and obesity using unique and large-scale data on 150,000 male siblings from the Swedish military enlistment. Our empirical analysis provides four important results. First, we provide the first evidence of a large adult male labor market penalty for being overweight or obese as a teenager. Second, we replicate this result using data from the United States and the United Kingdom. Third, we note a strikingly strong within-family relationship between body size and cognitive skills/noncognitive skills. Fourth, a large part of the estimated body-size penalty reflects lower skill acquisition among overweight and obese teenagers. Taken together, these results reinforce the importance of policy combating early-life obesity in order to reduce healthcare expenditures as well as poverty and inequalities later in life.

Educational homogamy and gender-specific earnings: Sweden, 1990-2009.

Several studies have shown strong educational homogamy in most Western societies, although the trends over time differ across countries. In this article, we study the connection between educational assortative mating and gender-specific earnings in a sample containing the entire Swedish population born 1960-1974; we follow this sample from 1990 to 2009. Our empirical strategy exploits a longitudinal design, using distributed fixed-effects models capturing the impact of partner education on postmarital earnings, relating it to the income development before union formation. We find that being partnered with someone with more education (hypergamy) is associated with higher earnings, while partnering someone with less education (hypogamy) is associated with lower earnings. However, most of these differences in earnings emerge prior to the time of marriage, implying that the effect is explained by marital selection processes rather than by partner education affecting earnings. The exception is hypogamy among the highly educated, for which there are strong indications that in comparison with homogamy and hypergamy, earnings grow slower after union formation.

Getting ready for the marriage market? The association between divorce risks and investments in attractive body mass among married Europeans.

This article explores to what extent married middle-aged individuals in Europe are governed by the risk of experiencing divorce, when shaping their physical appearance. The main result is that divorce risks, proxied by national divorce rates, are negatively connected to body mass index (BMI) among married individuals but unrelated to BMI among singles. Hence, it seems that married people in societies where divorce risks are high are more inclined to invest in their outer appearance. One interpretation is that high divorce rates make married people prepare for a potential divorce and future return to the marriage market.

Changes in alcohol consumption: an analysis of self-reported use of alcohol in a Swedish national sample 1988-89 and 1996-97.

AIM: To analyse factors associated with alcohol consumption, and how these changed over the period 1988-97, a period during which Sweden entered the European Union. METHODS: Data were used from two waves (1988-89 and 1996-97) of the representative longitudinal micro-level ULF survey in Sweden to estimate a two-part model of consumption. RESULTS: Experiencing financial stress, monthly salary, and not being married were all correlated with alcohol consumption, especially for males in 1988-89. In 1996-97 these correlations were much weaker, revealing a levelling-out trend towards conformity. The pattern was less clear for females. Further, the youngest age group (16-29 years) increased its consumption significantly more than the older age groups. CONCLUSION: There were significant changes in alcohol behaviour, especially for males, coinciding with Sweden joining the EU and preceding the very substantial general increase in consumption levels since 1998. This underlying process should be kept in mind when analysing the more recent trends. The results support the contention that alcohol policy should be a combination of measures targeting the whole population (e.g. via public health campaigns) with specific measures directed towards more vulnerable groups (e.g. young people).

Marital life course events and smoking behaviour in Sweden 1980-2000.

The protective effect of marriage on smoking has been extensively established in the literature. However, less is known about the dynamics of how smoking behaviour is connected to various marital life course events, and whether there are any gender discrepancies in this respect. In this article the connection between the marital life course and smoking is analysed from a stress-related perspective controlling for other socio-economic characteristics. We use information on 81,000 individuals from the Swedish longitudinal micro-level ULF (Survey of Living Conditions) database 1980-2000, which is randomly drawn from the sample population of all Swedes aged 16-84. Logistic regressions on current smoking status and changes in smoking behaviour of participants in the panel part of the data are estimated. The marital life course is strongly linked to smoking behaviour with being or getting married indicating low smoking risks and marital disruption indicating high risks. The divorced smoke to a higher extent than the widowed and there are signs that getting divorced implies higher risks than becoming widowed, both of taking up/relapsing and, for women, not being able to quit. Further, the results indicate that the connection between smoking cessation and living with a partner is stronger for men, whereas women are more affected by the propensity to start smoking after marital disruption. The protective effect of being married on smoking decreases with the age difference between spouses in households where the wife is older than the husband. Taken together, the results yield a rather complex pattern of smoking behaviour over the marital life course. Further, perceived financial stress is strongly connected to smoking and not being able to quit. Controlling for this effect still leaves a socio-economic status gradient in smoking.

Investments in social capital--implications of social interactions for the production of health.

This paper develops a theoretical model of the family as producer of health- and social capital. There are both direct and indirect returns on the production and accumulation of health- and social capital. Direct returns (the consumption motives) result since health and social capital both enhance individual welfare per se. Indirect returns (the investment motives) result since health capital increases the amount of productive time, and social capital improves the efficiency of the production technology used for producing health capital. The main prediction of the theoretical model is that the amount of social capital is positively related to the level of health; individuals with high levels of social capital are healthier than individuals with lower levels of social capital, ceteris paribus. An empirical model is estimated, using a set of individual panel data from three different time periods in Sweden. We find that social capital is positively related to the level of health capital, which supports the theoretical model. Further, we find that the level of social capital (1) declines with age, (2) is lower for those married or cohabiting, and (3) is lower for men than for women.

Health care for the elderly: two cases of technology diffusion.

Diffusion of medical technology and the growing proportion of elderly people in the population are generally regarded as major contributors to the increasing health care expenditure in the industrialised world. This study explores the importance of one specific factor in this process, the change in the use of technology among elderly patients. In some instances, a new technology is first used among younger patients and then gradually extended to the elderly. Two such cases are studied, both representing costly procedures: coronary bypass surgery (treatment of coronary heart disease) and dialysis (treatment of uraemia). In both cases, we demonstrate significant diffusion to older age groups. It is also tentatively concluded that the diffusion of technology could have an important effect on per capita health care expenditure among the oldest of the old.