澳大利亚 50 岁人群健康预期工作寿命的性别、教育和队列差异：一项纵向分析。

Gender, education, and cohort differences in healthy working life expectancy at age 50 years in Australia: a longitudinal analysis.

机构信息

Ageing Futures Institute, The University of New South Wales, Sydney, Australia; Neuroscience Research Australia (NeuRA), Sydney, Australia.

School of Mathematics and Statistics, University of Melbourne, Melbourne, Australia.

出版信息

Lancet Public Health. 2023 Aug;8(8):e610-e617. doi: 10.1016/S2468-2667(23)00129-9.

DOI:10.1016/S2468-2667(23)00129-9

PMID:37516477

Abstract

BACKGROUND

We aimed to estimate healthy working life expectancy (HWLE) at age 50 years by gender, cohort, and level of education in Australia.

METHODS

We analysed data from two nationally representative cohorts in the Household Income and Labour Dynamics in Australia survey. Each cohort was followed up annually from 2001 to 2010 and from 2011 to 2020. Poor health was defined by a self-reported, limiting, long-term health condition. Work was defined by current employment status. HWLEs were estimated with Interpolated Markov Chain multi-state modelling.

FINDINGS

We included data from 4951 participants in the cohort from 2001 to 2010 (2605 [53%] women and 2346 [47%] men; age range 50-100 years) and 6589 participants in the cohort from 2011 to 2020 (3518 [53%] women and 3071 [47%] men; age range 50-100 years). Baseline characteristics were similar between groups. Working life expectancy increased over time for all groups, regardless of gender or educational attainment. However, health expectancies only increased for men and people of either gender with higher education. Years working in good health at age 50 years for men were 9·9 years in 2001 (95% CI 9·3-10·4) and 10·8 years (10·4-11·3) in 2011. The corresponding HWLEs for women were 7·9 years (7·3-8·5) and 9·0 years (8·5-9·6). For people with low education level, HWLE was 7·9 years (7·3-8·5) in 2001 and 8·4 years (7·9-8·9) in 2011, and for those with high education level, HWLE rose from 9·6 years in 2001 (9·1-10·1) to 10·5 years in 2011 (10·2-10·9). Across all groups, there were at least 2·5 years working in poor health and 6·7 years not working in good health.

INTERPRETATION

Increases in length of working life have not been accompanied by similar gains in healthy life expectancy for women or people of any gender with low education, and it is not unusual for workers older than 50 years to work with long-term health limitations. Strategies to achieve longer working lives should address life-course inequalities in health and encourage businesses and organisations to recruit, train, and retain mature-age workers.

FUNDING

Australian Research Council.

摘要

背景

本研究旨在按性别、队列和教育程度估计澳大利亚 50 岁人群的健康预期工作寿命（HWLE）。

方法

我们分析了澳大利亚家庭收入和劳动力动态调查中两个具有全国代表性的队列的数据。每个队列在 2001 年至 2010 年和 2011 年至 2020 年期间每年进行一次随访。通过自我报告的、长期的健康状况来定义较差的健康状况。通过当前就业状况来定义工作。HWLE 使用插补马尔可夫链多状态模型进行估计。

结果

我们纳入了 2001 年至 2010 年队列的 4951 名参与者（2605 名[53%]女性和 2346 名[47%]男性；年龄范围 50-100 岁）和 2011 年至 2020 年队列的 6589 名参与者（3518 名[53%]女性和 3071 名[47%]男性；年龄范围 50-100 岁）的数据。两组之间的基线特征相似。所有群体的工作预期寿命都随着时间的推移而增加，无论性别或教育程度如何。然而，只有男性和受教育程度较高的人群的健康预期寿命有所增加。2001 年，50 岁男性健康工作年限为 9.9 年（95%CI 9.3-10.4），2011 年为 10.8 年（10.4-11.3）。同期女性的相应 HWLE 为 7.9 年（7.3-8.5）。受教育程度较低的人群在 2001 年的 HWLE 为 7.9 年（7.3-8.5），在 2011 年为 8.4 年（7.9-8.9），而受教育程度较高的人群的 HWLE 从 2001 年的 9.6 年（9.1-10.1）上升到 2011 年的 10.5 年（10.2-10.9）。在所有群体中，至少有 2.5 年的工作时间处于较差的健康状态，有 6.7 年的工作时间没有处于良好的健康状态。