Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, UK.
Department of Business Economics, Health and Social Care, Centre of Competence on Ageing, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.
Eur J Public Health. 2020 Aug 1;30(4):793-799. doi: 10.1093/eurpub/ckaa008.
Employment histories influence health. However, most studies have so far investigated cross-sectional associations between employment histories and health, failing to recognize health as a dynamic process in later life.
We use Waves 3-8 of the English Longitudinal Study of Ageing, including retrospective information on respondents' employment activities. We used dynamic hamming distances to summarize lifetime employment histories up to state pension age (64 for men and 59 for women). Multilevel growth curve models were then used to estimate the influence of lifetime employment histories on later life health trajectories over a 10-year period using quality of life (QoL), somatic health, and depression.
Net of selection effect and a host of contemporaneous material and social resources, men who exited early started off with poorer health than those with continuous attachment to the labour market but had a very similar health profile by the end of the 10-year period considered. Among women, better somatic health and higher QoL were observed among those who had employment breaks for family care, and this health advantage was maintained over time. Lifetime employment histories are not related to depression for either men or women.
Overall, differences in health by employment histories level off only among men who left earlier and those continuously employed. Flexible arrangements for men in poor health who benefit from leaving the labour market early and supporting women who wish to take breaks for family care may help reduce health inequalities in later life.
就业经历会影响健康。然而,迄今为止,大多数研究都调查了就业经历与健康之间的横断面关联,而没有认识到健康是晚年的一个动态过程。
我们使用了英国老龄化纵向研究的第 3-8 波,其中包括了受访者就业活动的回溯信息。我们使用动态汉明距离来总结终生的就业经历,直到国家养老金年龄(男性为 64 岁,女性为 59 岁)。然后,使用多层次增长曲线模型,使用生活质量(QoL)、躯体健康和抑郁来估计终生就业经历对 10 年期间的晚年健康轨迹的影响。
在消除了选择效应以及一系列同期物质和社会资源的影响后,早期退出的男性与那些一直与劳动力市场保持联系的男性相比,一开始的健康状况较差,但在考虑的 10 年期间结束时,他们的健康状况非常相似。在女性中,有家庭照顾就业中断的女性,其躯体健康状况更好,生活质量更高,这种健康优势随着时间的推移而保持。对于男性或女性来说,就业经历与抑郁无关。
总的来说,只有那些较早离职和一直就业的男性,其就业经历与健康之间的差异才会趋于平稳。对于那些健康状况不佳的男性来说,提前离开劳动力市场并支持那些希望为家庭照顾而休息的女性的灵活安排,可能有助于减少晚年的健康不平等。