Lynch Marty, Bucknall Milica, Jagger Carol, Kingston Andrew, Wilkie Ross
School of Medicine, Keele University, David Weatherall Building, Newcastle under Lyme, ST5 5BG, UK.
MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
Sci Rep. 2024 Mar 11;14(1):5936. doi: 10.1038/s41598-024-53095-z.
Although retirement ages are rising in the United Kingdom and other countries, the average number of years people in England can expect to spend both healthy and work from age 50 (Healthy Working Life Expectancy; HWLE) is less than the number of years to the State Pension age. This study aimed to estimate HWLE with the presence and absence of selected health, socio-demographic, physical activity, and workplace factors relevant to stakeholders focusing on improving work participation. Data from 11,540 adults in the English Longitudinal Study of Ageing were analysed using a continuous time 3-state multi-state model. Age-adjusted hazard rate ratios (aHRR) were estimated for transitions between health and work states associated with individual and combinations of health, socio-demographic, and workplace factors. HWLE from age 50 was 3.3 years fewer on average for people with pain interference (6.54 years with 95% confidence interval [6.07, 7.01]) compared to those without (9.79 [9.50, 10.08]). Osteoarthritis and mental health problems were associated with 2.2 and 2.9 fewer healthy working years respectively (HWLE for people without osteoarthritis: 9.50 years [9.22, 9.79]; HWLE with osteoarthritis: 7.29 years [6.20, 8.39]; HWLE without mental health problems: 9.76 years [9.48, 10.05]; HWLE with mental health problems: 6.87 years [1.58, 12.15]). Obesity and physical inactivity were associated with 0.9 and 2.0 fewer healthy working years respectively (HWLE without obesity: 9.31 years [9.01, 9.62]; HWLE with obesity: 8.44 years [8.02, 8.86]; HWLE without physical inactivity: 9.62 years [9.32, 9.91]; HWLE with physical inactivity: 7.67 years [7.23, 8.12]). Workers without autonomy at work or with inadequate support at work were expected to lose 1.8 and 1.7 years respectively in work with good health from age 50 (HWLE for workers with autonomy: 9.50 years [9.20, 9.79]; HWLE for workers lacking autonomy: 7.67 years [7.22, 8.12]; HWLE for workers with support: 9.52 years [9.22, 9.82]; HWLE for workers with inadequate support: 7.86 years [7.22, 8.12]). This study identified demographic, health, physical activity, and workplace factors associated with lower HWLE and life expectancy at age 50. Identifying the extent of the impact on healthy working life highlights these factors as targets and the potential to mitigate against premature work exit is encouraging to policy-makers seeking to extend working life as well as people with musculoskeletal and mental health conditions and their employers. The HWLE gaps suggest that interventions are needed to promote the health, wellbeing and work outcomes of subpopulations with long-term health conditions.
尽管英国和其他国家的退休年龄在不断提高，但在英格兰，人们从50岁起有望保持健康并继续工作的平均年数（健康工作预期寿命；HWLE）低于领取国家养老金的年龄。本研究旨在估计在存在和不存在与利益相关者相关的特定健康、社会人口统计学、身体活动和工作场所因素的情况下的HWLE，这些因素侧重于提高工作参与度。使用连续时间三状态多状态模型分析了英国老年纵向研究中11,540名成年人的数据。估计了与健康、社会人口统计学和工作场所因素的个体及组合相关的健康和工作状态之间转换的年龄调整风险率比（aHRR）。与没有疼痛干扰的人相比，有疼痛干扰的人从50岁起的HWLE平均少3.3年（6.54年，95%置信区间[6.07, 7.01]），而没有疼痛干扰的人为9.79年（[9.50, 10.08]）。骨关节炎和心理健康问题分别与健康工作年限减少2.2年和2.9年相关（没有骨关节炎的人的HWLE：9.50年[9.22, 9.79]；有骨关节炎的人的HWLE：7.29年[6.20, 8.39]；没有心理健康问题的人的HWLE：9.76年[9.48, 10.05]；有心理健康问题的人的HWLE：6.87年[1.58, 12.15]）。肥胖和缺乏身体活动分别与健康工作年限减少0.9年和2.0年相关（没有肥胖的人的HWLE：9.31年[9.01, 9.62]；有肥胖的人的HWLE：8.44年[8.02, 8.86]；没有缺乏身体活动的人的HWLE：9.62年[9.32, 9.91]；有缺乏身体活动的人的HWLE：7.67年[7.23, 8.12]）。工作中没有自主权或工作支持不足的工人预计从50岁起在健康状态下工作的时间分别减少1.8年和1.7年（有自主权的工人的HWLE：9.50年[9.20, 9.79]；缺乏自主权的工人的HWLE：7.67年[7.22, 8.12]；有支持的工人的HWLE：9.52年[9.22, 9.82]；支持不足的工人的HWLE：7.86年[7.22, 8.12]）。本研究确定了与50岁时较低的HWLE和预期寿命相关的人口统计学、健康、身体活动和工作场所因素。确定对健康工作生活的影响程度突出了这些因素作为目标，并且减轻过早退出工作的可能性对于寻求延长工作寿命的政策制定者以及患有肌肉骨骼和心理健康问题的人及其雇主来说是令人鼓舞的。HWLE差距表明需要采取干预措施来促进患有长期健康状况的亚人群的健康、福祉和工作成果。
