Browsing by Subject "RETIREMENT"

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  • Mattila-Holappa, Pauliina; Kausto, Johanna; Aalto, Ville; Kaila-Kangas, Leena; Kivimäki, Mika; Oksanen, Tuula; Ervasti, Jenni (2021)
    PurposeAlternative duty work is a procedure that enables an employee with a short-term disability to perform modified duties as an alternative to sickness absence. We examined whether the implementation of an alternative duty policy was associated with reduced sickness absence in the Finnish public sector.MethodsTwo city administrations (A and D) that implemented an alternative duty work policy to their employees (n=5341 and n=7538) served as our intervention cities, and two city administrations (B and C) that did not implement the policy represented the reference cities (n=6976 and n=6720). The outcomes were the number of annual days, all episodes, and short-term (
  • Komp-Leukkunen, Kathrin Susanne (2019)
    Life-courses describe people’s activities from the cradle to the grave. Because life-courses are typically complex, models are used to simplify their description. The most commonly used model is tripartite, representing lives in subsequent periods of education, work, and retirement. However, researchers criticize this model as limited in the activities considered, overly simplistic in the activity sequence, and blind to variation between life-courses. This article explores working age life-courses, which typically show high diversity. Multichannel sequence and cluster analyses are conducted on people’s activities from age 15 to 65. Data stem from the life-history interviews of the Survey of Health, Ageing and Retirement in Europe, capturing cohorts born before 1945. Findings show that three out of four working age life-courses are in line with the tripartite model. This share is particularly high among men, the cohort born 1935 to 1944, and in Northern and Eastern Europe. In contrast, a considerable share of women spent their working age on homemaking, especially women born before 1935, and those living in Southern Europe. Finally, a smaller number of men spent their working age on paid work, followed by a period of illness or of non-employment. The working age life-course patterns identified are used to develop alternative life-course models. However, for a parsimonious solution, the use of two models suffices. A combination of the tripartite model and the model equating middle age to homemaking captures the lives of more than nine out of ten older Europeans. The prevalence of working age life-course patterns in a population is country-specific, and the country differences align with the welfare regimes. This perspective makes working age life-courses characteristics of a society that can be used to map social inequalities at the macro-level and capture social change over time.
  • Halonen, Jaana I.; Kivimaki, Mika; Vahtera, Jussi; Pentti, Jaana; Virtanen, Marianna; Ervasti, Jenni; Oksanen, Tuula; Lallukka, Tea (2017)
    Objectives To examine the combined effects of childhood adversities and low adult socioeconomic status (SES) on the risk of future work disability. Methods Included were 34 384 employed Finnish Public Sector study participants who responded to questions about childhood adversities (none vs any adversity, eg, parental divorce or financial difficulties) in 2008, and whose adult SES in 2008 was available. We categorised exposure into four groups: neither (reference), childhood adversity only, low SES only or both. Participants were followed from 2009 until the first period of register-based work disability (sickness absence >9 days or disability pension) due to any cause, musculoskeletal or mental disorders; retirement; death or end of follow-up (December 2011). We ran Cox proportional hazard models adjusted for behavioural, health-related and work-related covariates, and calculated synergy indices for the combined effects. Results When compared with those with neither exposure, HR for work disability from any cause was increased among participants with childhood adversity, with low SES, and those with both exposures. The highest hazard was observed in those with both exposures: HR 2.53, 95% CI 2.29 to 2.79 for musculoskeletal disability, 1.55, 95% CI 1.36 to 1.78 for disability due to mental disorders and 1.29, 95% CI 1.20 to 1.39 for disability due to other reasons. The synergy indices did not indicate synergistic effects. Conclusions These findings indicate that childhood psychosocial adversity and low adult SES are additive risk factors for work disability.
  • Dudel, Christian; Myrskylä, Mikko (2020)
    Objectives: Little is known about the length of working life, even though it is a key indicator for policy-makers. In this paper, we study how the length of working life at age 50 has developed in the United States from a cohort perspective. Methods: We use a large longitudinal sample of U.S. Social Security register data that covers close to 1.7 million individuals of the cohorts born from 1920 to 1965. For all of these cohorts, we study the employment trajectories and working life expectancy (WLE) at age 50 by gender and nativity (native-born/foreign-born). For the cohorts with employment trajectories that are only incompletely observed, we borrow information from older cohorts to predict their WLE. Results: The length of working life has been increasing for the native-born males and females, and the younger cohorts worked longer than the older cohorts. However, WLE might soon peak, and then stall. The gap in WLE between the nativeborn and the foreign-born has increased over time, although latter group might be able to catch up in the coming years. Discussion: Our findings show that studying employment from a cohort perspective reveals crucial information about patterns of working life. The future development of the length of working life should be a major concern for policy-makers.
  • Hiilamo, Aapo; Shiri, Rahman; Kouvonen, Anne; Manty, Minna; Butterworth, Peter; Pietilainen, Olli; Lahelma, Eero; Rahkonen, Ossi; Lallukka, Tea (2019)
    Objective: We examined trajectories of work disability, indicated by sickness absence and disability retirement, among midlife public sector employees with and without common mental disorders (CMD) at baseline. We also examined adverse childhood events, occupational class, long-standing illness and health behaviour as determinants of the trajectories. Methods: A sample from the Helsinki Health Study was extracted comprising 2350 employees. Baseline characteristics were obtained from mail surveys conducted in 2000-2 and 2007. CMD were measured by the General Health Questionnaire. Participants were followed between the ages of 50-59. Work disability trajectories were modelled by the annual number of work disability months in group-based trajectory analysis. Multinomial regression was used to predict trajectory group memberships. Results: Three trajectories were identified: no work disability (consisting 59% of the all employees), stable/low (31%) and high/increasing disability (10%). Employees with CMD were more likely to belong to the stable/low (odds ratio 1.73 [95% confidence interval 1.37-2.18]), and the high/increasing (2.55 [1.81-3.59]) trajectories. Stratified models showed that the determinants of the trajectories were largely similar for those with CMD compared to those without CMD except that obesity was a somewhat stronger predictor of the high/increasing trajectory among employees with CMD. Limitations: The focus on midlife public sector employees limits the generalisability to other employment sectors and younger employees. Conclusions: CMD were strongly associated with a trajectory leading to early exit from employment and a stable/ low work disability trajectory. These findings have implications for interventions promoting work ability of employees with mental ill-health.
  • Perhoniemi, Riku; Tuulio-Henriksson, Annamari; Blomgren, Jenni; Laaksonen, Mikko (2021)
    Purpose Psychotropic drug consumption as a proxy measure of mental health problems during a disability pension process has only been studied among awarded applicants. This study examined psychotropic drug purchase trajectories among awarded and rejected disability pension applicants. Analyses were conducted in different diagnostic and sociodemographic groups. Methods A representative 70% sample of Finnish adults applying for disability pension due to a mental disorder in 2009-2011 (N = 18,087) was followed for 4 years in 3-month periods both before and after the pension decision. Register data on purchased drugs measured in defined daily doses (DDDs), gender, age, occupational class, unemployment history, and diagnostic group were used. The DDD levels and trends were analyzed using growth curve models. Results Psychotropic drug purchases increased before the pension decision and decreased gradually thereafter among both awarded and rejected applicants. The average DDD level was higher for rejected than awarded applicants before the decision but lower thereafter. The high pre-decision level for rejected applicants was explicit with a lower socioeconomic status. The pre-decision increase in DDDs was steeper for awarded applicants. Changes in DDDs before and after the decision were most prominent for depression, bipolar disorders, schizophrenia, and anxiety disorders. Conclusion Awarded and rejected disability pension applicants differed partly in their trajectories of psychotropic drug consumption. For awarded applicants, the steep rise of consumption prior to the award possibly reflects worsening occupational capacity. Early high consumption for rejected applicants signals long running mental health problems and calls for earlier support.
  • Airaksinen, Jaakko Matias; Jokela, Markus Mikael; Virtanen, Marianna; Oksanen, Tuula; Pentti, Jaana; Vahtera, Jussi; Koskenvuo, Markku Juhani; Kawachi, Ichiro; Betty, G. David; Kivimäki, Mika Juhani (2017)
    Work disability affects quality of life, earnings, and opportunities to contribute to society. Work characteristics, lifestyle and sociodemographic factors have been associated with the risk of work disability, but few multifactorial algorithms exist to identify individuals at risk of future work disability. We developed and validated a parsimonious multifactorial score for the prediction of work disability using individual-level data from 65,775 public-sector employees (development cohort) and 13,527 employed adults from a general population sample (validation cohort), both linked to records of work disability. Candidate predictors for work disability included sociodemographic (3 items), health status and lifestyle (38 items), and work-related (43 items) variables. A parsimonious model, explaining > 99% of the variance of the full model, comprised 8 predictors: age, self-rated health, number of sickness absences in previous year, socioeconomic position, chronic illnesses, sleep problems, body mass index, and smoking. Discriminative ability of a score including these predictors was high: C-index 0.84 in the development and 0.83 in the validation cohort. The corresponding C-indices for a score constructed from work-related predictors (age, sex, socioeconomic position, job strain) were 0.79 and 0.78, respectively. It is possible to identify reliably individuals at high risk of work disability by using a rapidly-administered prediction score.
  • Ervasti, Jenni; Airaksinen, Jaakko; Pentti, Jaana; Vahtera, Jussi; Suominen, Sakari; Virtanen, Marianna; Kivimäki, Mika (2019)
    Objectives We examined the extent to which an increase in physical activity would reduce the excess risk of work disability among overweight and obese people (body mass index >= 25kg/m(2)). Methods We used counterfactual modelling approaches to analyze longitudinal data from two Finnish prospective cohort studies (total N=38 744). Weight, height and physical activity were obtained from surveys and assessed twice and linked to electronic records of two indicators of long-term work disability (>= 90-day sickness absence and disability pension) for a 7-year follow-up after the latter survey. The models were adjusted for age, sex, socioeconomic status, smoking, and alcohol consumption. Results The confounder-adjusted hazard ratio (HR) of long-term sickness absence for overweight compared to normal-weight participants was 1.43 [95% confidence interval (CI) 1.35-1.53]. An increase in physical activity among overweight compared to normal-weight individuals was estimated to reduce this HR to 1.40 (95% CI 1.31-1.48). In pseudo-trial analysis including only the persistently overweight, initially physically inactive participants, the HR for long-term sickness absence was 0.82 (95% CI 0.70-0.94) for individuals with increased physical activity compared to those who remained physically inactive. The results for disability pension as an outcome were similar. Conclusions These findings suggest that the excess risk of work disability among overweight individuals would drop by 3-4% if they increased their average physical activity to the average level of normal-weight people. However, overweight individuals who are physically inactive would reduce their risk of work disability by about 20% by becoming physically active.
  • Danielsbacka, Mirkka; Tanskanen, Antti O.; Coall, David A.; Jokela, Markus (2019)
    Previous studies suggest grandparental childcare is associated with improved health and well-being of grandparents but limited information on the causal nature of this association exists. Here, we use the longitudinal Survey of Health, Ageing and Retirement in Europe (SHARE) of people aged 50 and above across 11 countries including follow-up waves between 2004 and 2015 (n = 41,713 person-observations from 24,787 unique persons of whom 11,102 had two or more measurement times). Between-person and within-person (or fixed-effect) regressions were applied, where between-person models show associations across participants and within-person models focus on each participant's variation over time. Health and well-being were measured according to self rated health, difficulties with activities of daily living (ADLs), depressive symptoms, life satisfaction and meaning of life scores. Across all analyses, childcare assistance provided by older adults to their adult children, was associated with increased health and well-being of grandparents. However, these associations were almost completely due to between-person differences and did not hold in within-person analyses that compared the same participants over time. Fewer ADL limitations for grandparents who provided childcare assistance was the only association that remained in the within-individual analyses. These findings suggest that there might be only limited causal association between grandchild care and grandparental well-being and that it may be specific to physical rather than cognitive factors. The results are discussed with regard to evolutionary psychology assumptions of altruistic behavior and positive health outcomes for the helper.
  • Lahti, Anna-Maria; Mikkola, Tuija M.; Salonen, Minna; Wasenius, Niko; Sarvimäki, Anneli; Eriksson, Johan G.; von Bonsdorff, Mikaela B. (2021)
    Senior houses provide social interaction and support, potentially supporting older people's physical and mental functioning. Few studies have investigated functioning of senior house residents. The aim was to compare functioning between senior house residents and community-dwelling older adults in Finland. We compared senior house residents (n = 336, 69% women, mean age 83 years) to community-dwelling older adults (n = 1139, 56% women, mean age 74 years). Physical and mental functioning were assessed using the SF 36-Item Health Survey. Loneliness and frequency of social contacts were self-reported. The analyses were adjusted for age, socioeconomic factors and diseases. Physical functioning was lower among men in senior houses compared to community-dwelling men (mean 41.1 vs. 46.4, p = 0.003). Mental functioning or the frequency of social contacts did not differ between type of residence in either sex. Loneliness was higher among women in senior houses compared to community-dwelling women (OR = 1.67, p = 0.027). This was not observed in men. Results suggest that women in senior houses had similar physical and mental functioning compared to community-dwelling women. Male senior house residents had poorer physical functioning compared to community-dwelling men. Women living in senior houses were lonelier than community-dwelling women despite the social environment.
  • Niska, Miira; Nikander, Pirjo (2021)
    Population ageing presents major challenges to the welfare system across the European Union. Consequently, emphasizing delayed retirement age and extended working lives abound in political discussions. Researchers have recognized numerous problems, which make the extended working life a challenging political task. One of these problems are citizens' negative attitudes toward delayed retirement and extended working life. In this paper, we approach this "attitude problem" from the perspective of discursive social psychology and analyze the variation in the way aspirations to extend working lives are evaluated by older workers. The data analyzed in the study consists of interviews where participants between 50 and 65 years of age comment on the political goal to extend working lives. The article sheds light on the "attitude problem" by turning the attention from underlying individual preferences to discursive resources used to undermine the political goal and the situational functions these evaluative practices have.
  • Pihlajamäki, Minna; Uitti, Jukka; Arola, Heikki; Korhonen, Mikko; Nummi, Tapio; Taimela, Simo (2020)
    Purpose Work disability (WD) as a medico-legal concept refers to disability benefits (DB) that are granted due to diseases that permanently reduce work ability. We studied whether an occupational healthcare instrument for the prediction of sickness absence (SA) risk-a health risk appraisal (HRA)-also predicts permanent WD. Methods HRA results were combined with registry data on DB of 22,023 employees from different industry sectors. We analysed how the HRA risk categories predict DB and considered occupational group, gender, age, and prior SA as confounding variables. Cumulative incidence function illustrates the difference between the HRA risk categories, and the Fine-Gray model estimates the predictors of WD during 6-year follow-up. Results The most common primary reasons for permanent WD were musculoskeletal (39%) and mental disorders (21%). Self-reported health problems in the HRA, labelled as "WD risk factors", predicted DB when controlling for age and prior SA. Hazard ratios were 10.9 or over with the lower limit of the 95% confidence interval 3.3 or over among those with two simultaneous WD risk factors. 14% of the females and 17% of the males with three or more simultaneous WD risk factors had received a DB, whereas the respective figures among those without findings were 1.9% and 0.3%. Conclusions Self-reported health problems in the HRA, especially multiple simultaneous WD risk factors, predict permanent WD among both genders across occupational groups. Screening WD risk with a self-administered questionnaire is a potential means for identifying high-risk employees for targeting occupational healthcare actions.
  • Head, Jenny; Chungkham, Holendro Singh; Hyde, Martin; Zaninotto, Paola; Alexanderson, Kristina; Stenholm, Sari; Salo, Paula; Kivimäki, Mika; Goldberg, Marcel; Zins, Marie; Vahtera, Jussi; Westerlund, Hugo (2019)
    Background: There are striking socioeconomic differences in life expectancy, but less is known about inequalities in healthy life expectancy and disease-free life expectancy. We estimated socioeconomic differences in health expectancies in four studies in England, Finland, France and Sweden. Methods: We estimated socioeconomic differences in health expectancies using data drawn from repeated waves of the four cohorts for two indicators: (i) self-rated health and (ii) chronic diseases (cardiovascular, cancer, respiratory and diabetes). Socioeconomic position was measured by occupational position. Multistate life table models were used to estimate healthy and chronic disease-free life expectancy from ages 50 to 75. Results: In all cohorts, we found inequalities in healthy life expectancy according to socioeconomic position. In England, both women and men in the higher positions could expect 82-83% of their life between ages 50 and 75 to be in good health compared to 68% for those in lower positions. The figures were 75% compared to 47-50% for Finland; 85-87% compared to 77-79% for France and 80-83% compared to 72-75% for Sweden. Those in higher occupational positions could expect more years in good health (2.1-6.8 years) and without chronic diseases (0.5-2.3 years) from ages 50 to 75. Conclusion: There are inequalities in healthy life expectancy between ages 50 and 75 according to occupational position. These results suggest that reducing socioeconomic inequalities would make an important contribution to extending healthy life expectancy and disease-free life expectancy.
  • van Raalte, Alyson A.; Sasson, Isaac; Martikainen, Pekka (2018)
  • Leskinen, Tuija; Suorsa, Kristin; Tuominen, Miika; Pulakka, Anna; Pentti, Jaana; Löyttyniemi, Eliisa; Heinonen, Ilkka; Vahtera, Jussi; Stenholm, Sari (2021)
    Purpose The randomized controlled trial REACT (NCT03320746) examined the effect of a 12-month consumer-based activity tracker intervention on accelerometer-measured physical activity among recent retirees. Methods Altogether 231 recently retired Finnish adults (age, 65.2 +/- 1.1 yr, mean +/- SD; 83% women) were randomized to intervention and control groups. Intervention participants were requested to wear a commercial wrist-worn activity tracker (Polar Loop 2; Polar, Kempele, Finland) for 12 months, to try to reach the daily activity goals shown on the tracker display, and to upload their activity data to a Web-based program every week. The control group received no intervention. Accelerometer-based outcome measurements of daily total, light physical activity (LPA), and moderate to vigorous (MVPA) physical activity were conducted at baseline and at 3-, 6-, and 12-month time points. Hierarchical linear mixed models were used to examine the differences between the groups over time. All analyses were performed by intention-to-treat principle and adjusted for wake wear time. Results The use of a commercial activity tracker did not increase daily total activity, LPA, or MVPA over the 12-months period when compared with nonuser controls (group-time interaction, P = 0.39, 0.23, and 0.77, respectively). There was an increase in LPA over the first 6 months in both the intervention (26 min center dot d(-1), 95% confidence interval [CI] = 13 to 39) and the control (14 min center dot d(-1), 95% CI = 1 to 27) groups, but the difference between the groups was not significant (12 min center dot d(-1), 95% CI = -6 to 30). In both groups, LPA decreased from 6 to 12 months. Conclusion The 12-month use of a commercial activity tracker does not appear to elicit significant changes in the daily total activity among a general population sample of recent retirees, thus highlighting the need to explore other alternatives to increase physical activity in this target group.
  • Airaksinen, Jaakko; Ervasti, Jenni; Pentti, Jaana; Oksanen, Tuula; Suominen, Sakari; Vahtera, Jussi; Virtanen, Marianna; Kivimäki, Mika (2019)
    Background: Smoking increases disability risk, but the extent to which smoking cessation reduces the risk of work disability is unclear. We used non-randomized nested pseudo-trials to estimate the benefits of smoking cessation for preventing work disability. Methods: We analysed longitudinal data on smoking status and work disability [long-term sickness absence (>= 90 days) or disability pension] from two independent prospective cohort studies-the Finnish Public Sector study (FPS) (n = 7393) and the Health and Social Support study (HeSSup) (n = 2701)-as 'nested pseudo-trials'. All the 10094 participants were smokers at Time 1 and free of long-term work disability at Time 2. We compared the work disability risk after Time 2 of the participants who smoked at Time 1 and Time 2 with that of those who quit smoking between these times. Results: Of the participants in pseudo-trials, 2964 quit smoking between Times 1 and 2. During the mean follow-up of 4.8 to 8.6 years after Time 2, there were 2197 incident cases of work disability across the trials. Quitting smoking was associated with a reduced risk of any work disability [summary hazard ratio = 0.89, 95% confidence interval (CI) 0.81-0.98]. The hazard ratio for the association between quitting smoking and permanent disability pension (928 cases) was of similar magnitude, but less precisely estimated (0.91, 95% CI 0.81-1.02). Among the participants with high scores on the work disability risk score (top third), smoking cessation reduced the risk of disability pension by three percentage points. Among those with a low risk score (bottom third), smoking cessation reduced the risk by half a percentage point. Conclusions: Our results suggest an approximately 10% hazard reduction of work disability as a result of quitting smoking.
  • Dudel, Christian; López Gómez, María Andrée; Benavides, Fernando G.; Myrskylä, Mikko (2018)
    While there has been considerable debate about extending the length of working life, relatively little is known about this issue. We use data from the Spanish Continuous Working Life Sample for 2004--2013 to calculate period working life tables, which in turn allows us to assess the impact of the financial crisis on working life expectancy in Spain. Before the recession hit, working life expectancy in Spain was around 38 years for males and 33 years for females. The recession had a tremendous impact on the Spanish labor market, but the effects differed considerably by gender and occupational category. Men working in skilled non-manual jobs were less affected, while men working in unskilled manual jobs lost close to 14 years of working life expectancy. Women were less affected than men. With working life expectancy decreasing, the average proportion of lifetime spent in unemployment and outside the labor market increased markedly, whereas the average number of years spent in retirement changed only a little. When we decompose losses in working life expectancy by age group, we find that economic fluctuations affect both older and younger workers. This result suggests that policies that focus on retirement ages only are incomplete. We also compare our findings to the results obtained by Sullivans method, which is based on prevalence rates rather than the incidence-based working life table approach. We find that the use of Sullivans approach does not accurately reflect the levels of and the trends in working life expectancy.
  • Lallukka, Tea; Ervasti, Jenni; Lundström, Erik; Mittendorfer-Rutz, Ellenor; Friberg, Emilie; Virtanen, Marianna; Alexanderson, Kristina (2018)
    Background-Although a stroke event often leads to work disability, diagnoses behind work disability before and after stroke are largely unknown. We examined the pre-event and postevent trends in diagnosis-specific work disability among patients of working age. Methods and Results-We included all new nonfatal stroke events in 2006-2008 from population-based hospital registers in Sweden among women and men aged 25 to 60 years (n=12 972). Annual days of diagnosis-specific work disability were followed for 4 years before and after stroke. Repeated measures negative binomial regression models using the generalized estimating equations method were fitted to examine trends in diagnosis-specific work disability before and after the event. Already during the 4 pre-event years, work disability attributed to circulatory diseases increased among women (rate ratio, 1.99; 95% confidence interval, 1.68-2.36) and men (rate ratio, 2.20; 95% confidence interval, 1.88-2.57). Increasing trends before stroke were also found for work disability attributed to mental disorders, musculoskeletal diseases, neoplasms, diseases of the nervous, respiratory, and digestive systems, injuries, and diabetes mellitus. As expected, a sharp increase in work disability days attributed to circulatory diseases was found during the first year after the event among both sexes. Overall, during 4 years after the stroke, there was a decreasing trend for circulatory diseases and injuries, whereas the trend was increasing for nervous diseases and diabetes mellitus. Conclusions-Work disability attributed to several mental and somatic diagnoses is higher already before a stroke event.
  • Dudel, Christian; Myrskylae, Mikko (2017)
    A key concern about population aging is the decline in the size of the economically active population. Working longer is a potential remedy. However, little is known about the length of working life and how it relates to macroeconomic conditions. We use the U.S. Health and Retirement Study for 1992-2011 and multistate life tables to analyze working life expectancy at age 50 and study the impact of the Great Recession in 2007-2009. Despite declines of one to two years following the recession, in 2008-2011, American men aged 50 still spent 13 years, or two-fifths of their remaining life, working; American women of the same age spent 11 years, or one-third of their remaining life, in employment. Although educational differences in working life expectancy have been stable since the mid-1990s, racial differences started changing after the onset of the Great Recession. Our results show that although Americans generally work longer than people in other countries, considerable subpopulation heterogeneity exists. We also find that the time trends are fluctuating, which may prove troublesome as the population ages. Policies targeting the weakest performing groups may be needed to increase the total population trends.