Social inequalities, stressful work and non-fatal cardiovascular disease: follow-up findings from the CONSTANCES Study.

BACKGROUND: Studies show that a disadvantaged socioeconomic position (SEP) and psychosocial stress at work are both independently associated with an increased risk of cardiovascular disease (CVD). But it is not clear if the effect of stress at work on CVD varies by SEP. METHODS: We used baseline and follow-up data from the French population-based cohort study CONSTANCES, including 48 383 employed women and men aged 30-70 years. Three SEP indicators (education, income, occupation), stressful psychosocial work as measured by effort-reward imbalance, pre-existing CVD and confounders were assessed at baseline, and incident non-fatal CVD events reported during annual follow-up (up to five follow-ups) were used as outcomes. The effect modification hypothesis was both investigated on an additive and multiplicative scale. RESULTS: SEP was inversely associated with CVD risk (eg, for low vs high income, OR 1.28 (95% CI 1.12 to 1.46)), and for all three components of stressful work CVD risks were significantly increased (eg, for effort-reward ratio OR 1.26 (95% CI 1.17 to 1.36)). Employees with a disadvantaged SEP showed moderately increased effect sizes of stressful work on CVD. However, no clear evidence of an effect modification was found. CONCLUSIONS: Disadvantaged SEP and stressful work contribute to higher CVD risk in this cohort. Despite moderately increased effect sizes for disadvantaged SEP groups, no evidence was found to support an effect modification hypothesis.

[Occupational differences of COVID-19 morbidity and mortality in Germany. An analysis of health insurance data from 3.17 million insured persons]. / Berufsbedingte Unterschiede bei COVID-19-Morbidität und -Mortalität in Deutschland. Eine Analyse von Krankenkassendaten von 3,17 Mio. Versicherten.

INTRODUCTION: During the COVID-19 pandemic, occupation was assumed to play a central role in the occurrence of infection and disease. For Germany, however, there are only a few studies that analyse occupational differences in risk of COVID-19, COVID-19-associated hospitalisation, and mortality. METHODS: The study uses longitudinal health insurance data from the research database of the Institute for Applied Health Research (InGef) with information on 3.17 million insured persons aged 18-67 years (1,488,452 women; 1,684,705 men). Outcomes (morbidity, hospitalisation, and mortality) were determined on the basis of submitted COVID-19 diagnoses between 1 January 2020 and 31 December 2021. Occupations were classified according to four groupings of the official German classification of occupations. In addition to cumulative incidences, relative risks (RR) were calculated - separately for men and women. RESULTS: There is an increased risk of disease in personal service occupations, especially in health care, compared to other occupations (RR for women 1.46; for men 1.30). The same applies to social and cultural service occupations (but only for women) and for manufacturing occupations (only for men). In addition, the risks for hospitalisation and mortality are increased for cleaning occupations and transport and logistics occupations (especially for men). For all three outcomes, the risks are higher in non-managerial occupations and differ by skill level (highest for unskilled jobs and lowest for expert positions). CONCLUSION: The study provides important findings on work- and gender-related differences in COVID-19 morbidity and mortality in Germany, which indicate starting points for structural infection protection measures.

Regional disparities in SARS-CoV-2 infections by labour market indicators: a spatial panel analysis using nationwide German data on notified infections.

BACKGROUND: Regional labour markets and their properties are named as potential reasons for regional variations in levels of SARS-CoV-2 infections rates, but empirical evidence is missing. METHODS: Using nationwide data on notified laboratory-confirmed SARS-CoV-2 infections, we calculated weekly age-standardised incidence rates (ASIRs) for working-age populations at the regional level of Germany's 400 districts. Data covered nearly 2 years (March 2020 till December 2021), including four main waves of the pandemic. For each of the pandemic waves, we investigated regional differences in weekly ASIRs according to three regional labour market indicators: (1) employment rate, (2) employment by sector, and (3) capacity to work from home. We use spatial panel regression analysis, which incorporates geospatial information and accounts for regional clustering of infections. RESULTS: For all four pandemic waves under study, we found that regions with higher proportions of people in employment had higher ASIRs and a steeper increase of infections during the waves. Further, the composition of the workforce mattered: rates were higher in regions with larger secondary sectors or if opportunities of working from home were comparatively low. Associations remained consistent after adjusting for potential confounders, including a proxy measure of regional vaccination progress. CONCLUSIONS: If further validated by studies using individual-level data, our study calls for increased intervention efforts to improve protective measures at the workplace, particularly among workers of the secondary sector with no opportunities to work from home. It also points to the necessity of strengthening work and employment as essential components of pandemic preparedness plans.

Long-term trends in psychosocial working conditions in Europe-the role of labor market policies.

BACKGROUND: Employees have witnessed rising trend in work stress over the last few decades. However, we know a little about country differences in those trends. Our article fills this gap in the literature by examining heterogeneities in trends in working conditions by country groups defined by their amount of investment into labor market policy (LMP) programs. Additionally, we provide findings on differences in occupational inequalities between country groups. METHODS: We use comparative longitudinal data of the European Working Conditions Surveys including cross-sectional information on employees from 15 countries surveyed in Waves 1995, 2000, 2005, 2010 and 2015. Estimation results are provided by three-way multilevel models with employees nested within country-years nested within countries. Our work stress measure is the proxy version of job strain based on the demand-control model. RESULTS: Our regression results indicate that for employees in countries with the least LMP spending job strain increased by 10% from 1995 to 2015 compared to a smaller and insignificant change in middle- and high-LMP countries. In low-LMP countries, inequalities in job strain also widened during the studied period: the gap in job strain between the highest- and lowest-skilled increased by 60% from 1995 to 2015. This contrasts a stable gap in middle- and high-LMP countries. CONCLUSIONS: Our results direct the attention to the vulnerable position of the least skilled and highlight that LMP investments may buffer some of the adverse impacts of globalization and technological changes and effectively improve the labor market situation of the least skilled.

[Does Vocational Reintegration After Medical Rehabilitation Differ in Terms of Social Status and Type of Rehabilitative Care?] / Unterscheidet sich die berufliche Wiedereingliederung nach medizinscher Rehabilitation bezüglich Sozialstatus und Art der rehabilitativen Versorgung?

BACKGROUND: Employees in a low socio-economic position (SEP) are more likely to leave the labour market after medical rehabilitation for health reasons than those in a better social position. So far, almost nothing is known about whether certain types of rehabilitative care can reduce this inequality in rehabilitation success. This paper examines whether certain types of care modify the SEP's influence on return-to-work (RTW). METHOD: The study is based on administrative data from the German statutory pension insurance on 266,413 medical rehabilitations of 253,311 persons fully integrated into working life. Poisson regression analyses were used to check whether there was a correlation between SEP (income, education, occupational position) and the probability of RTW in the year following the measure, and whether this correlation was lower in follow-up treatment (AHB), inpatient treatment or treatment with subsequent graded RTW compared to rehabilitation that did not meet these characteristics. RESULTS: People with a low income, education or occupational position were at increased risk of incomplete return to work after medical rehabilitation. This correlation was comparatively lower for all 3 SEP indicators when the return to work was gradual. In the case of AHB and inpatient rehabilitation, this only applied to income. CONCLUSION: Socio-economically disadvantaged population groups are comparatively more likely not to return fully to work after medical rehabilitation. These inequalities are less pronounced for certain types of rehabilitative care. This tends to be the case with an active structuring role of the care system. However, there is a need for further research on the modification of effects by the type of treatment. This should be further investigated using data collected for this purpose to exclude selection effects.

The role of pension contributions in explaining inequalities in depressive symptoms. Results from SHARE.

Aims: Research has established solid evidence that socioeconomic position impacts health. It is, however, still debated to what extent characteristics of entire employment histories are associated with health inequalities later on. This study investigates associations between contributing to pension schemes throughout entire employment histories and depressive symptoms in older men and women. Methods: We use retrospective life history data from the Survey of Health, Ageing and Retirement in Europe (SHARE), collected in 2008-2009 from retired men and women. Data include detailed information on previous employment histories (between age 25 and 60 years) that allows us to measure labour market involvements and pension contributions during past working lives. In addition, we measure elevated depressive symptoms using EURO-D. Results: We observe that employed work without contributing to pension schemes is associated with elevated depressive symptoms for women, even when taking the current household income into consideration. For men (but not for women), self-employed work without pension contributions is linked to elevated depressive symptoms. Conclusions: Our results indicate that studies linking previous employment participation to health after labour market exit should not only consider whether a person worked, but also whether he or she contributed to a pension scheme. In addition, our study points to interesting gender differences, where pension contributions matter most for women in employed work and for men in self-employed work.

Adverse employment histories, work stress and self-reported depression in the French CONSTANCES study.

BACKGROUND: Job instability and disadvantaged work were shown to be associated with poor mental health, but few studies analyzed these conditions in a life course perspective. In this study, adverse employment histories are retrospectively assessed and linked to self-reported depression. Furthermore, indirect effects of later stressful psychosocial work in terms of effort-reward imbalance are investigated. METHODS: With data from the French CONSTANCES cohort study of 13 716 male and 12 767 female employees aged 45 and older, we identify adverse employment histories between age 25 and 45, focussing on job discontinuity, job instability and cumulative disadvantage. Direct effects of these conditions on self-reported depression over a period of up to 5 years are analyzed, using discrete-time logistic regression. Indirect effects of stressful work at baseline are examined. RESULTS: Moderately elevated odds ratios of self-reported depression are observed among participants with discontinued employment histories (number of unemployment periods; years out of work for men). Effort-reward imbalance at work is consistently related to elevated risk of self-reported depression and explains parts of the association between discontinuous employment and depression. CONCLUSIONS: Applying a life course perspective to occupational health research extends current knowledge. Specifically, adverse employment histories in terms of recurrent job discontinuity are related to the risk of self-reported depression. This association is partly explained by exposure to a stressful psychosocial work environment. These results can instruct labour market policies and the development of targeted worksite interventions that address disadvantage throughout entire employment trajectories.

[Social inequalities in the regional spread of SARS-CoV-2 infections]. / Soziale Ungleichheit in der regionalen Ausbreitung von SARS-CoV-2.

BACKGROUND AND OBJECTIVE: It has not been adequately answered whether the spread of SARS-CoV­2 is influenced by social and economic factors. Earlier studies generally looked at cumulative incidences up to the analysis date and did not take into account the development of the spread over time. This study therefore focuses on the regional dynamic of new infections and their relationship to socioeconomic factors. Based on the literature we describe the state of knowledge and present our own analyses of administrative data from Germany. METHODS: For this study, we examined regional progress data of reported COVID-19 cases for 401 cities and counties in Germany and associated them with socioeconomic characteristics of the areas. Age-standardized weekly incidence rates were calculated for the period from 3 February 2020 to 28 March 2021. Macroindicators were added from the INKAR database (e.g., income, employment rate, and crowding). RESULTS: While areas with higher incomes and lower poverty had higher incidences in the first and at the beginning of the second wave of the pandemic, they increased significantly in low-income regions from December 2020 on. Regions with a high proportion of gainfully employed people in general and especially those in the manufacturing sector had high incidences, especially in the second wave and at the beginning of the third wave. A low mean living space per inhabitant was related to higher incidence rates since November 2020. CONCLUSION: The regional temporal course of the pandemic correlates with social and economic indicators. A differentiated consideration of these differences could provide information on target group-specific protection and test strategies and help to identify social factors that generally favor infections. An English full-text version of this article is available at SpringerLink as Supplementary Information.

[Higher risk of COVID-19 hospitalization for unemployed: an analysis of health insurance data from 1.28 million insured individuals in Germany]. / Erhöhtes Risiko eines COVID-19-bedingten Krankenhausaufenthaltes für Arbeitslose: Eine Analyse von Krankenkassendaten von 1,28 Mio. Versicherten in Deutschland.

BACKGROUND AND OBJECTIVE: Unemployment is related to poverty and is a risk factor for poor health. The present study investigates if unemployment increases the risk of COVID-19 hospitalization for men and women of working age in Germany. METHODS: The study uses the health insurance data from AOK Rhineland/Hamburg (from 1 January 2020 until 18 June 2020) of 1,288,745 persons aged between 18 and 65. Four employment situations are distinguished: (1) regular employment, (2) low-wage employment with social support, (3) unemployment with receipt of unemployment benefit 1, and (4) long-term unemployment with receipt of unemployment benefit 2. COVID-19 hospitalizations are measured on the basis of the ICD codes U07.1 and U07.2 reported by the hospitals. Multiple logistic regression models are calculated (adjusted for age and sex). RESULTS: During the observation period, 1521 persons had hospitalization with COVID-19 as primary or secondary diagnosis. Overall, this corresponds to a rate of 118 cases per 100,000 insured persons. Rates varied by employment situation. Compared with regularly employed persons, the odds ratio for a hospitalization was 1.94 (CI 95%: 1.74-2.15) for long-term unemployment, 1.29 (0.86-1.94) for unemployed, and 1.33 (0.98-1.82) for low-wage employment. CONCLUSION: The results are in line with earlier studies from the USA and Great Britain reporting socioeconomic inequalities in COVID-19 hospitalization risk. This provides the first empirical support that socioeconomic inequalities in the severity of COVID-19 also exists in Germany.

Assessing the association of university stress and physiological reactivity with decision-making among students.

Compared with age-matched employees, university students report higher levels of chronic stress and this may affect their decision-making. The impact of chronic stress and physiological reactivity upon cognitive function is receiving more attention, but few studies have empirically assessed the associations of these variables concurrently. Our aim was to investigate if chronic student stress, as assessed by effort-reward imbalance (ERI) and overcommitment, and physiological reactivity, were related to decision-making. As measures of physiological reactivity, we collected salivary alpha-amylase (sAA) and continuously recorded heart rate variability (HRV) data from male students (n = 79) at pretest and immediately after some computerized decision-making tasks (simple and choice- reaction times). Our findings suggest that students who are higher in overcommitment and who are more physiologically reactive (sAA and HRV indices) at the pretest stage may be more "at-risk" of poor decision-making than others. If others can replicate our findings in more diverse samples, this will contribute to an evidence base for interventions targeted at reducing overcommitment, ERI, and dysregulated autonomic reactivity to improve decision-making.

Social inequalities in medical rehabilitation outcomes-a registry-based study on 219 584 insured persons in Germany.

BACKGROUND: Given limited knowledge on the extent of social inequalities in longer-term work ability of people with a chronic disease, this study analyzes social inequalities of three consecutive indicators of work ability following medical rehabilitation in a large sample of insured employees. METHODS: Based on data from the German statutory pension insurance, a representative 20% random sample of all employed persons undergoing medical rehabilitation between 2006 and 2008 was included in a longitudinal analysis (n=219 584 persons). Three measures of consecutive work-related outcomes (physicians' assessment of work ability at discharge; return to work in the year thereafter; disability pension during follow-up) and socioeconomic position (SEP) (education, occupational position and income) were assessed. Adjusted relative risks (RRs) for each outcome were calculated according to SEP, applying Poisson regression analysis. RESULTS: The measures of SEP were associated with all three outcomes of work ability in the fully adjusted models. Relatively strongest relationships were observed for education as SEP measure, and they were particularly pronounced for 'low work ability' (RR=2.38 for lower secondary education compared to tertiary education; 95% CI: 2.26-2.51). Based on average marginal effects, absolute differences of work ability by SEP indicate a socially graded pattern, with only few exceptions. CONCLUSIONS: Despite Germany's universal access to medical and vocational rehabilitation social inequalities in longer-term work ability following chronic disease persist, thus calling for targeted programmes of prevention and occupational health promotion.

Is effort-reward imbalance at work associated with different domains of health functioning? Baseline results from the French CONSTANCES study.

PURPOSE: Despite its importance a comprehensive assessment of health functioning has rarely been included in epidemiological investigations of work-related health outcomes. In this study, we analyzed associations of a health-adverse psychosocial work environment with a comprehensive set of subjective and objective measures of health functioning that cover the three domains of affective, cognitive, and physical functioning. METHODS: Baseline data from the French CONSTANCES cohort study were used with a sample of 24,327 employed men and women aged 45-60. Psychosocial work environment was measured by the short version of the effort-reward imbalance (ERI) questionnaire. Measures of health functioning were depressive symptoms, semantic fluency, verbal memory, walking speed, standing balance and lung function. RESULTS: First, we replicated main psychometric properties of the ERI questionnaire in the French cohort. Second, ERI scales revealed consistent associations with depressive symptoms, but less consistent links to cognitive and physical function. Among men, we observed an association of stressful work with reduced lung function. CONCLUSIONS: This study demonstrated consistent associations of stressful work in terms of effort-reward imbalance with affective functioning in a large sample of male and female employees. Relationships with physical functioning were less consistent and restricted to men, and cognitive functioning was only marginally associated with stressful work. We also established the psychometric properties of the French short version of the ERI questionnaire, thus offering a tool for guiding and harmonizing further research in this field.

Gendered work-family trajectories and depression at older age.

Objectives: The paper identifies types of work-family trajectories of men and women and investigates their links with depression at older age. Method: We use data from the Heinz Nixdorf Recall study, with retrospective information on employment histories and parenthood between age 20 and 50 (1482 men and 1537 women, born between 1925 and 1955). We apply sequence analysis and group trajectories into six clusters for each gender. We test their association with two alternative measures of depression: self-reported depressive symptoms and intake of antidepressant medication. Multivariate models exclude participants with early life depression and adjust for age, marital status, education, and income. Results: We find clear differences of work-family trajectories between men and women, where women's trajectories are generally more diverse, and include family leaves and returns into full or part-time work. For men, work-family trajectories are neither related to depressive symptoms nor to medication intake. In contrast, women who returned into full-time work after family leave show more depression than those who return part-time, both in terms of depressive symptoms and intake of antidepressant medication. Conclusion: Our findings show gender differences in terms of work-family trajectories and their health-related consequences. In particular, findings suggest that mothers who return to full-time work are a vulnerable group for depression at older age and should be the focus of further research attention.

[Social inequality in reduced earning capacity among older employees : An analysis of routine data of the German statutory pension insurance]. / Soziale Ungleichheiten der Erwerbsminderung bei älteren Arbeitnehmern : Eine Analyse von Routinedaten der Deutschen Rentenversicherung.

BACKGROUND: The efforts to extend working lives are accompanied by the question of whether it is possible for all employees to work longer for health reasons. Existing studies show for example that particularly workers in a lower socioeconomic position have a comparatively higher risk to prematurely retire. It is therefore likely that an increase of the state pension age puts particular pressure on such workers; however, studies on socioeconomic differences of disability retirement focusing on older workers in Germany are missing. OBJECTIVE: The aim of this study was to investigate whether social inequality exists for reduced earning capacity also for older workers. MATERIAL AND METHODS: The study relied on administrative data of the German pension insurance (DRV). Detailed information on the course of insurance was available for a random sample of all insured persons born in the years 1947 and 1961 (aged 59 and 45 years respectively at the beginning of the observational period; n = 160,688). Using Cox regressions (adjusted for working hours, national citizenship and location of workplace) associations between three socioeconomic features (education, occupation and income) and the risk of disability retirement in the observational period were investigated. The analysis was carried out separately for both cohorts (born 1947 and 1961) of younger and older employees and separately for men and women. RESULTS AND CONCLUSION: The results showed an increased risk of reduction in earning capacity even for older workers with a low socioeconomic position compared to those in a higher position. For men this is true for all three socioeconomic features investigated and both cohorts. For women the association was also observed with the exception of education and occupational position for those born in 1947. In the efforts to extend working lives, special attention should be paid to persons in lower socioeconomic positions in order to protect them from new disadvantages.

Age differences in the association between stressful work and sickness absence among full-time employed workers: evidence from the German socio-economic panel.

PURPOSE: We aim to extend current knowledge on associations between stressful work and sickness absence, first, by studying associations between ERI and sickness absence among full-time employees from various occupations, and second, by investigating if associations vary by age. METHODS: We use data from four waves of the German socio-economic panel (GSOEP), collected among men and women between 2006 and 2012, with 9418 observations. Stressful work is measured with a short form of the ERI questionnaire. We investigate an imbalance between effort and reward (ER ratio) as well as the two main components ("high effort" and "low reward"). Sickness absence is measured by self-reported number of sickness days (assessed the following year). After descriptive analyses, we estimate a series of multivariable regressions, including tests for interactions between age and work stress. RESULTS: Each of the three indicators of stressful work is related to higher number of sickness days, with except of "high effort" in case of men. Findings remain significant after adjusting for social position (income, education and occupational class) and health. In addition, for both men and women, associations were slightly higher among older workers, though interactions did not reach statistical significance. CONCLUSION: Our findings support that stressful work is linked to sickness absence across a wide spectrum of jobs with varying incomes and educational levels, and also that associations are slightly more pronounced among older workers.

Underemployment, overemployment and deterioration of mental health: the role of job rewards.

OBJECTIVES: Working more (overemployment) or less (underemployment) than preferred has been associated with poor mental health in cross-sectional studies, but longitudinal evidence is scarce. We investigate whether under- and overemployment is associated with 2-year changes of mental health and whether associations vary by job rewards (i.e. high earnings, job security, promotion prospects and occupational prestige). METHODS: We used two waves of the German Socio-Economic Panel (GSOEP), with information on mental health collected in 2006 and 2008. Workers in paid employment (3266 men and 3139 women) who did not change jobs between 2006 and 2008, aged 20-60 years were selected. Under- and overemployment was assessed using the discrepancy between the actual and preferred working hours. Mental health was assessed using the Mental Component Summary (MCS) score, a subscale from the Short Form 12 Health Survey. Questions on rewards at work were added and divided into tertiles. Conditional change models were estimated to predict change in MCS. RESULTS: Findings indicate that overemployment and low reward at work (for men and women) were linked to a reduction in mental health. Underemployment was not related to a reduction in mental health. Albeit associations between under-/overemployment and mental health slightly differed across levels of reward, interactions did not reach statistical significance. CONCLUSIONS: Our findings demonstrate that overemployment was related to negative mental health change, and that this relationship held true both for people with high and with low reward at work.

Country differences of psychosocial working conditions in Europe: the role of health and safety management practices.

BACKGROUND: In times of demographic change, maintaining health and employability of older employees is important. In this context, studies show that stressful working conditions differ by countries. Yet, it is unclear if specific national management practices to deal with these conditions contribute towards explaining country differences. METHODS: This study combines two different data sources. The first one provides detailed information on psychosocial working conditions in 17 European countries, based on 12,284 employees from the Survey of Health, Ageing and Retirement in Europe (SHARE) and the English Longitudinal Study of Ageing (ELSA). We link this information to the second data source that provides information on health and safety management practices in each of the countries under study (collected among 17,477 managers at the level of companies in the Enterprise survey on new and emerging risks (ESENER)). We distinguish six different types of risk management procedures in the analysis. RESULTS: Results show that levels of psychosocial risks are generally lower in countries with more developed management practices, in particular if national management practices are marked by (1) procedures to deal with work stress, (2) information about whom to address in case of work-related psychosocial problems, and (3) health and safety services provided by psychologists. CONCLUSION: The findings underline the importance of a comprehensive psychosocial risk management approach in reducing work-related stress, as lower levels of psychosocial risks are linked to specific psychosocial risk management practices within companies, in particular those pointing to clear responsibilities and coordinated procedures in dealing with psychosocial risks.

[Work and health inequalities: The unequal distribution of exposures at work in Germany and Europe]. / Arbeit und gesundheitliche Ungleichheit : Die ungleiche Verteilung von Arbeitsbelastungen in Deutschland und Europa.

BACKGROUND: Health inequalities in the working population may partly be due to the unequal exposure to work-related risk factors among different occupational positions. Empirical data, however, exploring the distribution of exposures at work according to occupational position for Germany is missing. OBJECTIVES: This paper summarizes existing literature on occupational inequalities and discusses the role of working conditions. In addition, using European survey data, we study how various exposures at work vary by occupational class. MATERIALS AND METHODS: Analyses are based on the European Working Condition Survey, and we compare the German sample (n = 2096) with the sample from the EU-27 countries (n = 34,529). To measure occupational position we use occupational class (EGP-classes). First, we describe the prevalence of 16 different exposures at work by occupational class for men and women. Second, we estimate regression models, and thereby investigate if associations between occupational class and self-perceived health are related to an unequal distribution of exposures at work. RESULTS: For various exposures at work we found a higher prevalence among manual workers and lower-skilled employees for both physical and psychosocial conditions. With few exceptions only, this finding was true for men and women and consistent for Germany and Europe. CONCLUSION: Results indicate that the unequal distribution of health-adverse conditions at work contribute towards existing health inequalities among the working population.

Does labour market disadvantage help to explain why childhood circumstances are related to quality of life at older ages? Results from SHARE.

There is robust evidence that childhood circumstances are related to quality of life in older ages, but the role of possible intermediate factors is less explored. In this paper, we examine to what extent associations between deprived childhood circumstances and quality of life at older ages are due to experienced labour market disadvantage during adulthood. Analyses are based on the Survey of Health Ageing and Retirement in Europe (SHARE), with detailed retrospective information on individual life courses collected among 10,272 retired men and women in 13 European countries (2008-2009). Our assumption is that those who have spent their childhood in deprived circumstances may also have had more labour market disadvantage with negative consequences for quality of life beyond working life. Results demonstrate that advantaged circumstances during childhood are associated with lower levels of labour market disadvantage and higher quality of life in older ages. Furthermore, results of multivariate analyses support the idea that part of the association between childhood circumstances and later quality of life is explained by labour market disadvantage during adulthood.