Aging Research Center (ARC), Karolinska Institutet/Stockholm University, SE-171 65, Stockholm, Sweden.
Stress Research Institute, Stockholm University, SE-106 91, Stockholm, Sweden.
BMC Public Health. 2020 Sep 4;20(1):1360. doi: 10.1186/s12889-020-09431-9.
Global demographics are changing as societies all over the world are aging. This puts focus on maintaining functional ability and independence into older age. Individuals from lower social classes are at greater risk of developing limitations in physical function later in life. In this study, we investigated the mediating role of working conditions in the association between occupation-based social class and physical function measured as self-reported mobility limitations and objectively measured physical impairment in older age.
Two Swedish surveys, linked at the individual level, were used (n = 676-814 depending on the outcome). Follow-up time was 20-24 years. Multiple logistic regression analyses were performed with adjustments for age, sex, level of education, mobility, and health problems at baseline. This was followed by analyses of the size of the mediating effect of working conditions.
Working conditions seem to mediate 35-74% of the association between social class and physical impairment in older age. The pattern of mediation was primarily driven by passive jobs, i.e., low psychological demands and low control, among blue-collar workers. Working conditions did not mediate the association between social class and self-reported mobility limitations in older age.
The results of this study indicate that working conditions are important in combating the social gradient in healthy aging, contributing to the evidence regarding the magnitude of impact exerted by both the physical and psychosocial work environment separately and in conjunction.
全球人口结构正在发生变化，世界各地的社会都在老龄化。这使得人们更加关注老年人保持身体功能和独立性。来自社会较低阶层的个体在晚年更容易出现身体功能受限的风险。在这项研究中，我们研究了工作条件在职业社会阶层与身体功能之间的关联中的中介作用，身体功能通过自我报告的活动受限和老年时的身体损伤的客观测量来衡量。
使用了两项瑞典调查（根据结果，参与者数量在 676-814 人之间），在个体层面上进行了链接。随访时间为 20-24 年。采用多因素逻辑回归分析，对年龄、性别、教育程度、活动能力和健康问题进行了调整。然后分析了工作条件的中介效应大小。
工作条件似乎在社会阶层与老年身体损伤之间的关联中起中介作用，占比 35-74%。这种中介模式主要由蓝领工人中被动工作驱动，即低心理需求和低控制的工作。工作条件并不能解释社会阶层与老年时自我报告的活动受限之间的关联。
本研究结果表明，工作条件在消除健康老龄化中的社会阶层差异方面具有重要作用，这为物理和心理社会工作环境各自以及共同产生的影响的重要性提供了证据。
