Shiri Rahman, Poutanen Joonas, Härmä Mikko, Ervasti Jenni, Haukka Eija
Finnish Institute of Occupational Health, Helsinki, Finland. Correspondence to: Rahman Shiri, Finnish Institute of Occupational Health, P.O. Box 18, FI-00032 Työterveyslaitos, Finland.
Scand J Work Environ Health. 2025 May;51(3):135-145. doi: 10.5271/sjweh.4216. Epub 2025 Mar 4.
This systematic review and meta-analysis aimed to identify risk factors for unemployment among middle-aged workers.
Searches were carried out in PubMed, Web of Science and Google Scholar until November 2024, focusing on observational longitudinal studies that involved workers aged 40-64 years. Three reviewers evaluated the quality of the studies. A random-effects meta-analysis was employed, and heterogeneity and publication bias were assessed.
Out of 10 432 reports, 19 longitudinal studies (N=374 585 participants) were included in the review. The meta-analysis identified multiple risk factors associated with unemployment, including suboptimal self-rated general health [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.21-1.70], mental health conditions [HR 1.48, 95% CI 1.30-1.68, particularly depressive symptoms (HR 1.42, 95% CI 1.14-1.76)], low job control (HR 1.30, 95% CI 1.17-1.43), and lack of physical activity (HR 1.56, 95% CI 1.13-2.15). Additionally, a higher risk of unemployment was observed among individuals with ≤12 years of education (HR 1.17, 95% CI 1.00-1.36), those who are unmarried, separated, or widowed (HR 1.43, 95% CI 1.14-1.79), and immigrants (HR 1.26, 95% CI 1.11-1.44). Age, gender, smoking, alcohol consumption, musculoskeletal disorders, cardiovascular and respiratory diseases, digestive diseases, diabetes, neoplasm, and limitations in daily activities did not increase unemployment risk.
This meta-analysis highlights the impact of mental health conditions, low job control, and lack of leisure-time physical activity on unemployment risk among middle-aged workers. Interventions aimed at improving mental health and increasing job control and physical activity could reduce unemployment risk.
本系统评价和荟萃分析旨在确定中年工人失业的风险因素。
在PubMed、科学网和谷歌学术上进行检索，截至2024年11月，重点关注涉及40 - 64岁工人的观察性纵向研究。三位评审员评估了研究质量。采用随机效应荟萃分析，并评估了异质性和发表偏倚。
在10432篇报告中，19项纵向研究（N = 374585名参与者）被纳入综述。荟萃分析确定了与失业相关的多个风险因素，包括自我评定的总体健康状况欠佳[风险比（HR）1.44，95%置信区间（CI）1.21 - 1.70]、心理健康状况[HR 1.48，95% CI 1.30 - 1.68，特别是抑郁症状（HR 1.42，95% CI 1.14 - 1.76）]、工作控制感低（HR 1.30，95% CI 1.17 - 1.43）以及缺乏体育活动（HR 1.56，95% CI 1.13 - 2.15）。此外，受教育年限≤12年的个体（HR 1.17，95% CI 1.00 - 1.36）、未婚、分居或丧偶者（HR 1.43，95% CI 1.14 - 1.79）以及移民（HR 1.26，95% CI 1.11 - 1.44）的失业风险更高。年龄、性别、吸烟、饮酒、肌肉骨骼疾病、心血管和呼吸系统疾病、消化系统疾病、糖尿病、肿瘤以及日常活动受限并未增加失业风险。
这项荟萃分析突出了心理健康状况、工作控制感低以及缺乏休闲时间体育活动对中年工人失业风险的影响。旨在改善心理健康、增强工作控制感和体育活动的干预措施可能会降低失业风险。
