Institute for Medical Sociology, Medical Faculty, Heinrich-Heine-University Düsseldorf, P,B,101007, 40001 Duesseldorf, Germany.
BMC Public Health. 2013 Nov 21;13:1086. doi: 10.1186/1471-2458-13-1086.
Maintaining health and work ability among older employees is a primary target of national labour and social policies (NLSP) in Europe. Depression makes a significant contribution to early retirement, and chronic work-related stress is associated with elevated risks of depression. We test this latter association among older employees and explore to what extent indicators of distinct NLSP modify the association between work stress and depressive symptoms. We choose six indicators, classified in three categories: (1) investment in active labour market policies, (2) employment protection, (3) level of distributive justice.
We use data from three longitudinal ageing studies (SHARE, HRS, ELSA) including 5650 men and women in 13 countries. Information on work stress (effort-reward imbalance, low work control) and depressive symptoms (CES-D, EURO-D) was obtained. Six NLSP indicators were selected from OECD databases. Associations of work stress (2004) with depressive symptoms (2006) and their modification by policy indicators were analysed using logistic multilevel models.
Risk of depressive symptoms at follow-up is higher among those experiencing effort-reward imbalance (OR: 1.55 95% CI 1.27-1.89) and low control (OR: 1.46 95% CI 1.19-1.79) at work. Interaction terms indicate a modifying effect of a majority of protective NLSP indicators on the strength of associations of effort - reward imbalance with depressive symptoms.
Work stress is associated with elevated risk of prospective depressive symptoms among older employees from 13 European countries. Protective labour and social policies modify the strength of these associations. If further supported findings may have important policy implications.
在欧洲，维护老年员工的健康和工作能力是国家劳动和社会政策（NLSP）的主要目标。抑郁症是导致提前退休的一个重要因素，与工作相关的慢性压力与抑郁症的风险增加有关。我们在老年员工中检验了这后一种关联，并探讨了不同 NLSP 指标在多大程度上改变了工作压力与抑郁症状之间的关联。我们选择了六个指标，分为三类：（1）对积极劳动力市场政策的投资，（2）就业保护，（3）分配公正程度。
我们使用了来自三个纵向老龄化研究（SHARE、HRS、ELSA）的数据，这些研究包括了 13 个国家的 5650 名男性和女性。收集了工作压力（努力-回报失衡、低工作控制）和抑郁症状（CES-D、EURO-D）的信息。从经合组织数据库中选择了六个 NLSP 指标。使用逻辑多层模型分析了 2004 年工作压力（努力-回报失衡、低工作控制）与 2006 年抑郁症状之间的关联及其受政策指标的影响。
在随访时，经历努力-回报失衡（OR：1.55 95%CI 1.27-1.89）和低控制（OR：1.46 95%CI 1.19-1.79）的人患抑郁症状的风险更高。交互项表明，大多数保护性 NLSP 指标对努力-回报失衡与抑郁症状之间关联的强度有调节作用。
工作压力与来自 13 个欧洲国家的老年员工中前瞻性抑郁症状的风险增加有关。保护性的劳动和社会政策会改变这些关联的强度。如果进一步得到证实，这些发现可能具有重要的政策意义。
