MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.
MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, England.
BMC Public Health. 2021 Mar 23;21(1):574. doi: 10.1186/s12889-021-10610-5.
Loneliness is an important public health issue associated with mortality and morbidity. Often researched amongst older people, less is known about risk factors for loneliness among adults aged 50-64 years who are in work. We investigated (a) if exit from the workforce increases the odds of loneliness; (b) whether adverse psychosocial work factors are associated with increased odds of loneliness over 2 years of follow-up; and (c) whether the association is stronger among subjects still working compared with those who have exited the workforce.
Data came from the Health and Employment After Fifty (HEAF) study, a large population cohort who provided questionnaire information about work and health at baseline and 2 annual follow-ups. Logistic regression was used to explore the association between psychosocial risk factors and loneliness at follow-up 2, with adjustment for loneliness at baseline, sex, age, self-rated health, living alone, and mental health diagnosis.
Of the initial 8134 participants, 4521 were working at baseline and provided data for this analysis. Of those, 507 (11.2%) were defined as lonely at 2 years' follow-up. Exiting the workforce was not significantly associated with loneliness (OR = 1.1, 95%CI: 0.7-1.7). However, negative psychosocial work factors predicted loneliness at follow-up. After mutual adjustment, lack of choice at work (OR: 1.5, 95%CI: 1.1-1.9), often lying awake worrying about work (OR: 1.4, 95%CI: 1.0-1.9) and perceived not coping with physical demands of the job (OR: 1.3, 95%CI: 1.0-1.7) were independent predictors, with associations robust to adjustment for demographic factors and health. Associations were only slightly altered when we restricted the sample to those who remained in work until the end of follow-up.
Loneliness amongst middle-aged working adults is not predicted by permanent work exit but is predicted by individuals' perceptions about their work. Provision of good-quality work, matched to the capacity of the older worker, could prevent loneliness.
孤独是一个重要的公共卫生问题，与死亡率和发病率有关。孤独通常在老年人中进行研究，而对于 50-64 岁仍在工作的成年人的孤独风险因素知之甚少。我们调查了：（a）退出工作是否会增加孤独的几率；（b）在 2 年的随访中，不良的心理社会工作因素是否与孤独几率增加有关；以及（c）与退出工作的人群相比，这种关联在仍在工作的人群中是否更强。
数据来自健康与五十岁后就业（HEAF）研究，这是一项大型人群队列研究，参与者在基线和 2 次年度随访时提供了关于工作和健康的问卷信息。使用逻辑回归来探讨心理社会风险因素与随访 2 时孤独之间的关联，调整了基线孤独、性别、年龄、自我评估健康状况、独居和心理健康诊断的影响。
在最初的 8134 名参与者中，有 4521 人在基线时工作，并提供了这项分析的数据。其中，507 人（11.2%）在 2 年随访时被定义为孤独。退出工作与孤独之间没有显著关联（OR=1.1，95%CI：0.7-1.7）。然而，负性的心理社会工作因素预测了随访时的孤独。在相互调整后，工作缺乏选择（OR：1.5，95%CI：1.1-1.9）、经常因工作而失眠（OR：1.4，95%CI：1.0-1.9）和感觉无法应对工作的身体需求（OR：1.3，95%CI：1.0-1.7）是独立的预测因素，这些关联在调整人口统计学因素和健康状况后仍然稳健。当我们将样本限制在那些一直工作到随访结束的人时，关联略有改变。
中年在职成年人的孤独并不取决于永久性的工作退出，而是取决于个体对工作的看法。提供高质量的工作，与老年工人的能力相匹配，可以预防孤独。
