Work ability of Thai older Workers in Southern Thailand: a comparison of formal and informal sectors.

ABSTRACT

BACKGROUND: Thai society is becoming an ageing society. Independent older persons need to be able to continue to work after retirement. The Work Ability Index (WAI) is an assessment tool for improving the health and work environment of the older workers. The objective of this study is to explore work ability and its related factors among older workers in formal and informal sectors in southern Thailand. METHODS: This cross-sectional study with multistage sampling focused on 324 Thai older workers, aged between 45 and 70 years, working in Nakhon Si Thammarat province. Data on sociodemographic status, health history, and work-related factor questionnaires were collected, including anthropometric measures and the WAI instrument between March and September 2019. Descriptive and logistic regression analyses were used to examine associations. RESULTS: The participants were predominantly general labourers (23.8%) and female (70.7%). Nearly half of them had noncommunicable chronic diseases (NCDs) (48.2%) and were obese (more than 60%). Approximately 60% (59.9%) engaged in safe working practices. The participants sometimes received occupational health services (51.9%) and frequently accessed health promotion services (78.1%). There was a significant difference in the total average WAI score of the formal and informal workers 40.6 (S.D. = 4.6) and 37.5 (S.D. = 5.0), respectively. The multivariate analysis showed that workers aged 55 years and older (adj. OR = 1.45; 95% CI [1.21, 1.74]), those with NCDs (adj. OR = 2.85; 95% CI [1.69, 4.80]), and those who were exposed to unsafe working practices (adj. OR = 2.11; 95% CI [1.26, 3.55]) had a higher risk of a poor to moderate WAI. CONCLUSIONS: Most of the older workers had good to excellent work ability. Older age and the presence of NCDs were negatively associated with good to excellent work ability. Safe working practices improved older workers' work ability. Integrated occupational health protections and health promotion programmes for older informal workers should be provided by community health services to improve work ability.