Blomqvist Sandra, Westerlund Hugo, Alexanderson Kristina, Magnusson Hanson Linda L
Stress Research Institute, Stockholm University, SE-106 91, Stockholm, Sweden.
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
BMC Public Health. 2020 May 5;20(1):618. doi: 10.1186/s12889-020-08589-6.
A maintained psychological wellbeing is important in order to continue working longer and remain active into older age. However, little is known about impact of different organizational factors, such as downsizing, on the mental health of older workers exiting the labor market. The aim in this study was to investigate trajectories of purchases of psychotropic drugs in relation to labor market exit later in life in a context with and without downsizing.
People living in Sweden, born 1941-1951, exiting paid work via unemployment, sickness absence/disability pension, or old-age pension were followed from 2005 to 2013 regarding purchases of psychotropic drugs. Individuals employed at a workplace closing down or downsizing with ≥18% between two subsequent years were compared to employees exiting from workplaces without downsizing or workplace closure. Generalized estimating equations was applied to derive trajectories of annual prevalence of purchased antidepressants, sedatives and anxiolytics from 4 years before to 4 years after a labour market exit.
During the period around the exit, old-age retirees experiencing a downsizing/workplace closure did not decrease their purchases of sedatives (OR 1.01 95% CI 0.95-1.07) while the unexposed decreased their purchases during this period (OR 0.95 95% CI 0.92-0.98). Similar differences concerning sedatives and antidepressants between exposed and unexposed were seen for those exiting via sickness absence or disability pension. Furthermore, a significant difference in purchases of anxiolytics was observed between those exposed to downsizing (OR 1.10 95% CI 0.97-1.24) and the unexposed (OR 0.98 95% CI 0.91-1.06) exiting via old-age retirement during the time before the exit.
Downsizing or workplace closure, although weakly, was associated with higher prevalence of psychotropic drugs certain years around the labor market exit. The results support the idea that involuntary labor market exit in mature adulthood may negatively affect the development of mental health.
保持心理健康对于延长工作年限并在老年时保持活力至关重要。然而，对于诸如裁员等不同组织因素对退出劳动力市场的老年员工心理健康的影响，我们知之甚少。本研究的目的是在有和没有裁员的背景下，调查精神药物购买轨迹与晚年劳动力市场退出之间的关系。
对1941年至1951年出生、通过失业、病假/残疾养老金或老年养老金退出有偿工作的瑞典居民，从2005年至2013年跟踪其精神药物购买情况。将在随后两年间关闭或裁员幅度≥18%的工作场所工作的员工，与从没有裁员或工作场所关闭的工作场所离职的员工进行比较。应用广义估计方程得出从劳动力市场退出前4年到退出后4年购买抗抑郁药、镇静剂和抗焦虑药的年患病率轨迹。
在退出前后期间，经历裁员/工作场所关闭的老年退休人员并未减少其镇静剂购买量（比值比1.01，95%置信区间0.95 - 1.07），而未经历此情况的人员在此期间减少了购买量（比值比0.95，95%置信区间0.92 - 0.98）。对于通过病假或残疾养老金退出的人员，暴露组和未暴露组在镇静剂和抗抑郁药方面也有类似差异。此外，在退出前的时间段内，通过老年退休退出的暴露于裁员的人员（比值比1.10，95%置信区间0.97 - 1.24）和未暴露人员（比值比0.98，95%置信区间0.91 - 1.06）在抗焦虑药购买方面存在显著差异。
裁员或工作场所关闭虽然影响较弱，但与劳动力市场退出前后若干年精神药物较高的患病率相关。结果支持成年后期非自愿劳动力市场退出可能对心理健康发展产生负面影响这一观点。
