Tag Archives: Employment

Being accommodating in the workplace: could it help close the disability employment gap? 

In 2020, 8.4 million people of working age (16-64) reported that they were disabled which is 20% of the working age population. 52 percent of disabled people aged 16-64 were in work compared with  81 percent of non-disabled people. It’s a gap the Department for Work and Pensions wants to tackle, but good research for evidence-based policy solutions in this area is thin on the ground. New research from Tarani Chandola and Patrick Rouxel suggests that ‘workplace accommodations’ such as flexible or part-time working, mentorship and training and support could help the Government achieve its 10 year ambition to halve the disability employment gap.

In its 2017 policy paper Improving lives: the future of work, health and disability, the DWP committed to seeing the number of  disabled work in work rise by 1 million from 3.5 to 4.5 million over the subsequent 10 years. 

When we talk about the disability employment gap we mean the difference between the number of people with a disability who are in work compared with those without a disability. The gap comes about through people having to leave work through ill-health or the onset of physical or mental health problems whilst working, together with the fact that if you’re disabled, you have considerably lower chances of getting a job in the first place. The large majority (83 percent) become disabled whilst they are in work and once they do the likelihood of them being in work a year later is much reduced.

There has been little research in this area, particularly when it comes to looking at all this in the round in order to get the bigger picture as it relates to all workers who use some sort of work place accommodation or adjustment to how, where and when they carry out the role. In order to make sound policy recommendations that work for disabled people and employers, the Government has been looking to develop a more comprehensive evidence base. 

Rather than starting with a person’s medical condition, we thought it could be useful to examine which workers (no matter the state of their health) are able to access e.g. a technical solution that means they can fulfil a role they otherwise wouldn’t be able to, as well as a range of flexible arrangements such as working hours, modified duties, being based at home, having access to a mentor. 

We wanted to try to establish who and how these arrangements and adaptations help to remain in work.

Barriers faced

We made use of information on more than 6,000 participants from the Life Opportunities Survey , which looks specifically at the barriers disabled people face in participating in various aspects of life including work. 

Around a third of the people we looked at who were in work reported some sort of impairment – a problem with their sight, hearing, mobility, pain, breathing, learning mental health or with a range of other conditions and disability-related issues. They were more likely to be out of work a year later than peers with no impairment, particularly if their impairments were to do with mobility or dexterity in which case they were three times more likely to be unemployed.

Workers with some sort of impairment or disability who had modified work duties or hours were more likely to remain economically active (in work or looking for work) than those who reported no such accommodations.

Modifications

A modified work area or equipment led to workers being twice as likely to stay in work. Indeed the more modifications reported, the more likely workers with an impairment were to be in work one year later.

Particularly noteworthy was how true this was for workers with mental impairments. Those who had no workplace accommodations were over 2/3rds (or 70 percent) less likely to remain in work than workers with no mental impairment.

This stark gap closed where two or more accommodations were reported. Also interesting was the fact that people with mental impairments were considerably less likely than those who reported physical pain to report an increase in their workplace accommodations. 

Looking at the wider picture of who accesses work accommodations and why, the main reason was not actually related to disability at all, but with having caring responsibilities.

The key things we learn from all this are that despite the evidence that workers with mental impairments could benefit considerably from workplace accommodations, they are less likely to have their workplace adjusted to take account of it.

This is something that could be a focus for policymakers and employers looking to close the disability employment gap. It should be especially helpful in informing managers and supervisors who have a crucial role in creating healthy and inclusive workplaces where all can thrive and progress. 

The role of workplace accommodations in explaining the disability employment gap in the UK is research by Tarani Chandola and Patrick Rouxel and is published in Social Science & Medicine.

Could having a psychologically demanding job actually be good for you?

Recent research has highlighted that those in psychologically demanding jobs which don’t offer possibility of control are more likely to become ill or to leave the labour market early. But a new study carried out in Sweden suggests the picture may be more complex than previously thought – for some workers, having a demanding job can be associated with good outcomes. Kristin Farrants from the Karolinska Institutet outlines what she and colleagues found and what it might mean for extending people’s working lives.

Governments across the developed world are interested in exploring how people can be enabled to extend their working lives. And a key part of that discussion has focused on how working conditions affect the likelihood that workers will stay on longer.

We know from earlier research that the working environment can affect how people feel about working into later life – if they are in jobs which are demanding but which don’t give them much control, they tend to want to leave. But until now we didn’t know much about what actually happened – do those intentions turn into reality? And what is the relationship between the demands of the job and the amount of control the worker has, when it comes to working after the usual retirement age?

We used nationwide register data from Statistics Sweden, to study all the 55-64 year-olds living and working in Sweden in December 2001. We followed up the same individuals 11 years later, in 2012, to see whether they were still working.

As predicted, we found that those who were in jobs with low levels of control in 2001 were less likely to be in paid work in 2012, while the reverse was true for those with a high level of control over their work tasks.

But when it came to how demanding the job was, the picture was more nuanced. Overall, those with more demanding jobs were less likely to have old-age pension, sick-leave benefits, or social assistance, 11 years on, than those with less demanding jobs, while those with low-demand, low-control jobs were less likely than others to carry on working.

Women and men

But there were significant differences between women and men. We found that when it came to control at work, women who had a high level of control over their work tasks were more likely to stay on in paid work, even if their jobs were not very demanding. For men, this was only the case if their jobs were both high-demand and high-control.

A possible explanation for these gender differences is that the jobs market in Sweden is highly gendered: perhaps the difference is in the type of jobs men and women do, rather than in the level of control or stress they have. It could also be due to differences in other factors, such as family needs, income or health.

Our findings support the underlying theory, which was first proposed in the 1970s by Robert Karasek. His Job Demand Control Model suggests it is high demands in combination with low control that leads to stress which can be bad for our health. Karasek’s model suggests that it is not stress, per se, which makes us ill – it is the mismatch between being asked to do a lot and yet not feeling in control of how we do it. So if our jobs are very demanding yet we feel we are in the driving seat, that makes a big difference to us.

Staying in paid work

Why does this matter? Across the developed world we have falling birth rates and increasing life expectancy – so it’s important to governments that people stay in jobs rather than retiring early. And if workers can stay healthy, this will be easier to achieve.

We already know that low levels of control are associated with high levels of disease, disability and sick leave. But the evidence about the role of job demands has been more equivocal.

Our research adds new depth to the picture. High-stress jobs are not necessarily bad; in fact a demanding job can be a positive factor in older people’s lives. Jobs which stretch and challenge us can keep us moving on in the labour market – and as well help us stay healthy.

Associations between combinations of job demands and job control among 616,818 people aged 55-64 in paid work with their labour market status 11 years later: a prospective cohort study, by Kristin Farrants, Jenny Head, Elisabeth Framke, Reiner Rugulies and Kristina Alexanderson, is published in International Archives of Occupational and Environmental Health .

Lockdown – just how stressful has it been?

2020 is a year many will be happy to see the back of. It has been a stressful time for sure with periods of lockdown creating major challenges for our day to day work and family lives. But have the stresses and strains associated with lockdown affected the mental health of the UK population as a whole? Tarani Chandola and colleagues have been using specially collected COVID19 data to investigate.

On March 23, the UK found itself in its first lockdown, a direct result of rising infection rates and deaths caused by the pandemic. The new normal for many was working from home whilst trying to homeschool children. The weekly shop involved queues and masks and social distancing. Getting a doctor or dentist appointment or scheduled medical treatment took on a whole new dimension. Trips to the pub, cinema and theatre were things people could no longer look forward to and looking out for elderly relatives and friends became more important and challenging in equal measure.

Gradually through the Summer months, many of these restrictions were eased and the majority of children returned to school. Businesses including pubs, gyms and hairdressers were able to re-open albeit with strict social distancing and hygiene measures in place.

The severity of the restrictions combined with the direct effects of the disease itself created what might be described as a perfect storm of increased potential stresses likely to adversely affect the mental health of people everywhere. Most of us will have felt fearful about catching the disease, and many will have experienced additional worries for already vulnerable family and friends. The realities of working at home brought its own challenges while for others being furloughed or losing their job brought additional anxiety. 

Although there have been widespread reports of worsening mental health and wellbeing through the first UK lockdown, there have also been some reports that this eased somewhat through April and May although not back to pre-pandemic levels.

COVID-19 data

In our research, which made use of data from Understanding Society including its specially-collected COVID-19 study, we were able to look across a slightly longer period of time at the experiences of between 13,000 and 17,000 people in the UK. These were people who had been involved in the survey for many years, so there was a great deal of background information available as a backdrop for our research. 

We wanted to see whether more people were reporting struggling with mental health problems and to what extent the prevalence of problems was directly related to the stresses and strains of lockdown and the pandemic specifically. We also wanted to see if, after the initial ‘shock’ of events in April eased in subsequent months as people began to adapt and ‘get used to’ their new circumstances.

Between April and July study participants were asked a range of questions directly related to the disease itself including whether they had had it, been tested for it or experienced symptoms. There were also questions about any other health treatment, their families, work and money- related concerns such as struggling to pay the bills.

Every month people were asked about their work status so we could see for example  who was employed, self-employed, working reduced hours, furloughed or been made redundant. They were also asked about hours spent on childcare and homeschooling or whether they felt lonely.

Common mental disorder

Before lockdown just under 25 per cent of people in the UK had experienced mental health issues and this rose to just over 37 per cent in April, so more than a third of the population. There was a gradual dropping off of cases through to July (just under 26 per cent) taking things almost back to pre-lockdown levels. 

The percentage of new cases of mental health problems among participants in April was double (around 28 percent) what it was in the preceding 12 months.

And recovery rates from a mental health issue dropped from pre-lockdown months through April to June but picked up again in July, by which time social restrictions had been eased considerably and, our research shows, potential stressors around COVID itself, juggling work and family responsibilities and health, business and money concerns had decreased for most.

The number of people who reported having some sort of health limiting condition and having to cancel or postpone medical treatment halved from April to July. Over the same period, the number of self-employed people who said their business had been adversely affected also went down from 3.6 percent to 0.6 percent. Employees who reported being made unemployed or being on reduced hours also more than halved and there was only a small increase in the proportion of people describing themselves as ‘economically inactive’. 

Rates of reporting ‘often feeling lonely’ went down from 8.8 to 6.7 percent and fewer people reported having to spend more than 16 hours a week on childcare or homeschooling although there was a small increase in the proportion of people spending 1-15 hours on those tasks.

For some people, problems with paying bills remained an issue throughout the period,  although the percentage of people who said they found things very difficult financially or who said the future looked bleaker financially reduced somewhat from April onwards. 

Which stresses affected people most?

The strongest link between lockdown related stress was loneliness. People in the survey who reported ‘often feeling lonely’ were 11 to 16 times more likely to have mental health problems from the April to July compared to those who never felt lonely. Other important stressors were having COVID-19 symptoms and always working from home. 

Self-employed people whose businesses were negatively impacted by COVID-19 were more likely to develop a mental health problem compared to their peers whose businesses were not. And by July, employees who became unemployed, or were made redundant or whose work hours were reduced were over two times as likely to develop a problem compared with those who were unaffected. 

Adults doing16 hours or more a week on childcare or home schooling were about 1.4 times more likely to develop a problem compared to those who had no children or did not spend any time on childcare. 

Adults who were finding it quite or very difficult financially were 2.4 times more likely to develop a mental health issue compared to those who were living comfortably. Similarly, adults who expected their future finances to be worse off than now were 1.6 times more likely.

Longitudinal analysis

Our findings from looking at this group of people across April to July are in line with other surveys undertaken by the Office of National Statistics and the UCL COVID-19 study of 90,000 adults. We add to that picture by looking more closely at which stressful circumstances are most likely to drive up incidences of poor mental health during a pandemic of this nature. 

We conclude that despite the lifting of many lockdown conditions by July and a decrease in the levels of many of the psychological and social stressors, these stressors continued to drive poor mental health among people who were lonely and those who were made unemployed or redundant, had financial problems or had childcare or home schooling duties.

As unemployment and redundancy increase in the labour market, an inevitable result of recent events, it will be important to keep monitoring the mental health consequences of unemployment. It is Interesting also to note that employees who were furloughed had about the same levels of mental health problems as employees whose job hours were not affected. This suggests that the government measures to protect jobs also had positive mental health benefits for those employees who were able to keep their jobs albeit in a “furloughed” state.

The mental health impact of COVID-19 and lockdown-related stressors among adults in the UK is research by Tarani Chandola, Cara Booker, Meena Kumari and Michaela Benzeval and  is published in Psychological Medicine

Leaving school: how do work and family transitions affect women’s wealth and wellbeing later on?

How have the early adult lives of a generation of young women who grew up after the war impacted on their lives now? Baowen Xue and Anne McMunn from the ESRC International Centre for Lifecourse Studies at UCL discuss two new papers which look at life satisfaction, mental health and economic wealth among older women. Their findings suggest early marriage and domestic labour are linked to worse outcomes later in life. 

The move out of education into work, marriage and parenthood is a sensitive time for young people and can set the course for their later lives. So which circumstances have turned out to be beneficial, and which have been less so?

We used data from the English Longitudinal Study of Ageing, ELSA, to look for answers to these questions. Our study followed a sample of over-50s who have been interviewed every two years since 2002. A Life history interview was conducted additionally to collect information about their  education, work and family lives.

We identified a group of almost 4,000 women born before 1956 who answered questions on life satisfaction and mental health, and in our second paper a smaller group of just under 1800 for whom income data was also available.

Our hypothesis as we set out on the research was that those who married and had children later, and who therefore tended to have stronger ties to work early on, would have better mental health in later life. This largely proved to be true, though remaining single was not the answer: this group tended to suffer from isolation and loneliness later in life.

We identified six types of transition from education into work and family life: Early marriage and domestic labour, later marriage and domestic labour, later marriage and later work entry, later marriage and early work entry, early work entry and remaining single, and a group whose experiences were mixed and included lone parenthood, marriage with or without children and a mixture of employment types.

Early motherhood and domestic labour

The key finding in our study was that women who took on motherhood and domestic labour at an early stage were more likely to suffer from depression and lower life satisfaction in later life than those who went to work early and married late. Those with mixed histories and those who stayed single and childless were also more vulnerable to poor mental health and low life satisfaction. But those who started work late – often through staying in education – and also married late had the highest life satisfaction and the lowest level of mental illness.

We found that these effects could by and large be linked to socioeconomic status: those from more privileged backgrounds tended to gain higher educational qualifications, to enter work later and to marry later, and that set them on a path to a better quality of life later on. Conversely, those from less privileged backgrounds tended to gain fewer qualifications, to marry earlier and to have a poorer quality of life later.

A second paper, also using ELSA data asked a linked question: how does leaving full-time education and becoming a home-maker at an early stage affect women’s economic wealth later in life?

We took the life histories of just under 1800 women born between 1939 and 1952, and looked at when they left education as well as how their entry into work affected their financial situation in later life. 

We found those who left education early and went straight into domestic roles were four times less likely than their more educated peers to be in the highest household wealth bracket in later life.

Women who started work between the ages of 21 and 24 were 40 per cent more likely to be in professional or managerial jobs than those who left school by age 16 and started work early. They were 53 per cent more likely to be in the top earnings bracket for women of their age and were almost four times more likely to be in the top bracket for total household wealth.

We concluded that the age at which women leave education plays a pivotal role in their later economic, personal and mental wellbeing. For the generation of women who are now pensioners, an early entry into domestic rather than paid labour cast a long shadow, while higher education conferred particular advantages. 

As higher education and later partnership have become the norm for today’s young women, these studies will form a baseline which will one day enable us to see whether their experiences compare or contrast with those of their grandmothers’ generation.

The Long Shadow of Youth: Girls’ Transition From Full-Time Education and Later-Life Subjective Well-Being in the English Longitudinal Study of Ageing is research by Baowen Xue, Penny Tinkler and Anne McMunn and is published in the Journals of Gerontology: Social Sciences

Girls’ transition to adulthood and their later life socio-economic attainment: Findings from the English Longitudinal Study of Ageing is research by BaoWen Xue, Penny Tinkler, Paola Zaninotto and Anne Mc Munn and is published in Advances in Life Course Research.

Anne McMunn and BaoWen Xue are based at the ESRC International Centre for Lifecourse Studies in Society and Health at UCL. Paola Zaninotto works with the English Longitudinal Study of Ageing at UCL and Penny Tinkler is based at the Manchester Institute for Collaborative Research on Ageing.

Constriction worker

Is temporary employment bad for your health?

How is the health of those in insecure jobs affected by their working lives? Rachel Sumner and colleagues* have discovered some types of work may be just as strongly linked with poor health as unemployment is.

It’s long been acknowledged that there’s a link between unemployment and poor health. A recent Government Green Paper put it starkly:

“People who are unemployed have higher rates of mortality and a lower quality of life. This is an injustice that we must address.”

But is any job really better than no job? Or could some types of employment actually be linked just as strongly to poor health?

We looked at the issue using data from the Understanding Society study, which took blood samples from more than 4500 people aged between 16 and 64 who were either working or unemployed in 2010 and 2011– we excluded those who were retired, homemaking, not working due to incapacity or in education.

Overall, 7.6 per cent of our sample were unemployed. Amongst the employed, 81.8 per cent were permanently employed, 5.3 per cent were temporarily employed and 12.9 per cent were self-employed.

Health indicators

These samples were used to show whether the study participants had raised levels of fibrinogen or C-reactive protein (CRP), both of which are inflammatory markers and are associated with increased risk of heart disease. Healthy lifestyles decrease CRP levels, while obesity, physical inactivity and smoking increase them.

We compared the levels of these markers in those who were unemployed, permanently employed, temporarily employed and self-employed. We took into account a range of individual, social and health factors which might also influence the levels of these markers.

We didn’t find links between employment status and levels of CRP – but we did find links with fibrinogen.

We looked at how the levels of fibrinogen in different types of employee compared with those who were unemployed. And while those in permanent jobs or self-employed had lower levels of this marker, those in temporary work had similar levels to the unemployed.

So, not all types of work are equally beneficial in health terms – and in particular, temporary work would seem to be linked with worse health than other types. Indeed, in health terms we may actually be just as well off being unemployed as we are in an insecure job.

Why does this matter? It matters because less stable types of employment have grown in recent decades, with many workers employed on fixed-term contracts and experiencing uncertain job conditions. This has already been shown to have negative psychological consequences.

And since the recent global recession, which happened just before our data was collected, both unemployment and temporary employment have expanded. The European Union has a higher temporary employment rate than the OECD average  – 14.2 per cent compared with 11.2 per cent in 2016.

Levels of temporary employment in the UK are lower than the EU average – just six per cent in 2017 and four per cent in 2019  – but temporary employment has become more common since the financial crisis, particularly among young people. The rate of young people in the UK going into precarious employment has already resulted in poorer mental health.

Lessons for policymakers

If temporary employment is associated with an increased risk of mortality then earlier research which has simply compared unemployment with employment has not captured the complexities of the situation.

In conclusion, our findings would suggest there is little difference between the health effects of temporary employment and unemployment, using these particular indicators.  And given the continuing rise of precarious modes of employment across developed countries, this has significant implications for public health. Policymakers should encourage employers to expand the use of permanent contracts.

Unemployment, employment precarity, and inflammation, by Rachel C. Sumner, Rachel Bennett, Ann-Marie Creaven and Stephen Gallagher, is published in Brain, Behavior and Immunity.

Rachel Sumner and Rachel Bennett are based at the School of Natural & Social Sciences, University of Gloucestershire, United Kingdom; Ann-Marie Creaven and Stephen Gallagher are at the Health Research Institute, Department of Psychology, University of Limerick, Ireland.

Young woman sat by window

Are some types of job bad for your mental health? And how can employers ensure poor mental health does not lead to early retirement?

Mental illness is a major cause of early retirement – but do those who are forced to leave work early for this reason get better afterwards? What is the relationship between work stress and mental health? A new study of public sector workers in Finland suggests there is a link – and there are important lessons for employers. Tarani Chandola from the ESRC International Centre for Lifecourse Studies was among the authors of the study.

One way in which we can track the prevalence and level of mental illness is by looking at the use of psychotropic medication – that is, medication which can alter one’s mental state. This group of drugs includes common antidepressants, anti-anxiety drugs and antipsychotic medication. 

If there is a link between work stress and mental illness, then we should expect those forced to leave work for this reason to get better after retirement. So by tracking the levels of psychotropic medication among a group of workers before and after retirement, we could find out the extent to which there was such a link.

We were able to use data from a long-term study of Finnish public sector workers to examine the issue more closely. 

It matters because previous studies have shown an increase in the use of this group of drugs among all those who take disability retirement, particularly those whose retirement was due to mental ill health. Those from higher social classes saw the biggest drop in medication use after retirement, suggesting there are social factors at play here, too.

Global issues

The effect does seem to vary around the globe, though – some studies from Asia found an increase, rather than a decrease, in mental health problems after leaving work. But in Europe, retirement has often been found to be followed by an improvement in both mental and physical health. Retirees have reported sleeping better, feeling less tired and generally feeling a greater sense of wellbeing. 

We were able to use data from the Finnish Public Sector study cohort study, which followed all employees working in one of 10 towns and six hospital districts between 1991 and 2005. The study included participants from a wide range of occupations including administrative staff, cleaners, cleaners and doctors, and they were followed up at four-year intervals regardless of whether they were still in the same jobs. Their survey responses were linked to a register of medication purchases for at least two years before retirement and two years after.

We had information on 2,766 participants who took retirement because of disability. Uniquely, the data included both participants’ use of medication and their perceived levels of work stress. So we were able to ask whether there were differences in this pre and post-retirement effect between those in low and high-stress jobs.

Specifically, we looked at something called effort-reward imbalance – that is, when workers put in too much effort at work but get few rewards in compensation: according to a recent review, this carries an increased risk of depressive illness. 

If our theories were correct, we would see a decline in the use of psychotropic medication after disability retirement, and it would be greatest among those with high levels of effort-reward imbalance. Along with mental illness the other major cause of disability retirement in Finland is musculoskeletal disease, so we categorised our sample in three groups – mental illness, musculoskeletal disease and ‘other.’ Eight out of 10 in the sample were women, and three out of 10 reported high effort-reward imbalance before retirement.

Unsurprisingly, those who retired due to a mental disorder had the greatest increase in psychotropic drug use before retirement. And those who were in high-stress, low-reward jobs had higher levels of medication use than those who were not. But after retirement, there was no difference in psychotropic drug use between those with high vs low effort-reward imbalance. It looked as though stopping work in high stress jobs reduced the need for higher psychotropic medication use among those workers who exited the labour market for mental health reasons.  

Retirement because of musculoskeletal disease or other causes was not associated with any similar link between stress level and psychotropic medication.

Lessons for employers

Our study showed that among people retiring due to mental disorders, those in high-stress, low-reward jobs benefited most from retirement. So it’s likely that they could benefit from the alleviation of work-related stress before retirement, too.

In conclusion, if employers could find ways of reducing the levels of stress suffered by employees suffering from mental ill-health, their early exit from paid employment might be prevented and their working lives might be extended. 

Psychotropic medication before and after disability retirement by pre-retirement perceived work-related stress was published in the European Journal of Public Health, Vol. 0, No. 0, 1–6. 

The other authors were Jaana Halonen, Taina Leinonen, Ville Aalto, Tuula Oksanen, Mika Kivimäki and Tea Lallukka of the Finnish Institute of Occupational Health; Hugo Westerlund and Marianna Virtanen of the Stress Research Institute, Stockholm University; Martin Hyde of the Centre for Innovative Ageing, Swansea University; Jaana Pentti, Sari Stenholm and Jussi Vahtera of the Department of Public Health, University of Turku; Minna Mänty of the Department of Public Health, University of Helsinki; Mikko Laaksonen of the Research Department, Finnish Center for Pension.

These authors also have the following additional affiliations: Jaana Halonen; Stress Research Institute, Stockholm University; Jaana Pentti; Department of Public Health, University of Turku; Minna Mänty; Statistics and Research, City of Vantaa, Finland; Mika Kivimäki, Department of Public Health, University of Helsinki and Department of Epidemiology and Public Health, University College London; Marianna Virtanen, School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu; Tea Lallukka, Department of Public Health, University of Helsinki.

Are universal state pensions discriminating against those in lower-skilled jobs?

With the state pension age likely to rise further in coming years, are policymakers right to link pension eligibility to average life expectancy? In a one-size-fits-all system, which social groups will lose out? Dr Emily Murray and colleagues* used census data to look at who lives longest after leaving work.

In most industrialised countries, the eligibility age for state pensions is being increased. Between 2011 and 2018, the United Kingdom government raised the State Pension Age for women from age 60 to 65, to match that for men, and a further increase to age 67 for both genders is planned by 2028. A further increase to age 68 by 2039 has been mooted.

Yet our state pension system ignores some very basic facts – it doesn’t take into account the wide disparities in health and life expectancy between different social classes. Those in professional occupations can expect to live longer and to enjoy good health for longer than those in manual jobs. For example, the average 50 year-old man in a professional job can expect to enjoy a further 25 years of good health, while a man the same age in a manual occupation can only expect 18: a seven-year difference. That is why lower social class groups are more likely to find themselves on disability benefit.

We wanted to look more closely at these occupational social class differences in the amount of time older adults live after they stop work, and in particular at the extent to which these differences are due to health.

We used the Office for National Statistics Longitudinal Study, a one per cent representative sample of respondents to the English and Welsh censuses since 1971.  For our analysis, we included respondents who were aged 50-75 at the time of the 2001 census and who had stopped work by 2011 – the average age of stopping was 58 for women and 60.2 for men. These workers were born in 1951 or earlier, so men would have been eligible for state pension at 65 and women at 60.

That gave us a sample of 76,485 people, and over the next 10 years we were able to monitor deaths  – by 2011 14.6 per cent of the women and 25.1 per cent of the men had died.

We could see that for both genders, those in lower social classes tended to die younger – professional women lived two years longer than unskilled women, and professional men three years longer than unskilled men.

We estimated professional women in good health would live five years longer than unskilled women in poor health, while for men the gap would be five and a half years.

But despite these longevity gaps, those from lower social groups were facing more years between leaving work and being able to draw their state pensions – because they left work earlier.

We estimated that if two women were 65 in 2001, the woman who had worked in an unskilled occupation would live five years longer after leaving work than the professional woman with good health – because the unskilled woman would have left at a younger age. Two men in the same circumstances would live on average 25.0 and 19.5 years from stopping work to death.

The most likely explanation is that poor health has a greater impact on the ability of manual workers to continue working than it does on non-manual workers.  It is however important to note that associations between social class and post-work years were not entirely explained by health, and we feel more research is needed on this.

Poor health

But the conclusion is clear: our results show that a uniform state pension age disproportionately affects the poorest among us, because on average they must wait longer between stopping work and qualifying for their state pension, at a time when they are likely to be in poor health. This is despite the fact that they are likely to have started work younger and therefore to have worked and paid contributions for just as many years as their better-off peers.

The solution to this inequality is not straightforward. The preferred strategy for UK policymakers is to support individuals to stay in work for longer, and there is evidence that the average age of leaving work exit is increasing.  However, over half of women and two-fifths of men  still fall out of the labour market before state pension age.

Some researchers have suggested that pension ages should directly reflect life expectancy differences.  Alternatively the age requirement could be dropped and pension eligibility could be based solely on the number of years in work.

We believe a two-year earlier pension age may be more appropriate for individuals who work in manual occupations, given that they leave work earlier than professional workers not in good health.  With rises in pension age already in law, and evidence of stalling life expectancy, it is vital that researchers and policy-makers assess how these rises will influence financial security and health for the most vulnerable in society.

Inequalities in time from stopping paid work to death: findings from the ONS Longitudinal Study, 2001 to 2011 is by Emily T Murray,  Ewan Carr, Paola Zaninotto, Jenny Head, Baowen Xue, Stephen Stansfeld, Brian Beach and  Nicola Shelton.

*Emily T Murray, Ewan Carr, Paola Zaninotto, Jenny Head, Nicola Shelton and Baowen Xue are based at the Department of Epidemiology and Public Health, University College London.

Ewan Carr is also based at the department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London.

Stephen Stansfeld is based at Queen Mary University of London, Wolfson Institute of Preventive Medicine, Centre for Psychiatry, London, EC1M 6BQ, UK

Brian Beach is based at the International Longevity Centre – UK, SW1P 3QB, London, UK.

Woman doing housework

Domestic work – why do women still do the lion’s share?

A recent international report suggests men need to increase their time spent doing unpaid care work by a minimum of 50 minutes per day in order to do 50 per cent of the work. The report calls for bold measures to help all men do their fair share of this work by 2030 and thus promote gender equality. So what do we know about how modern couples in the UK divide unpaid domestic work and the drivers behind that? A new study from Anne McMunn at the ESRC International Centre for Lifecourse Studies at University College London investigates why greater workplace equality has not yet been matched by a more equitable division of labour at home.

Some studies suggest education is the key to equality within the home – that women with better education, and therefore greater earning power, are in a stronger negotiating position when it comes to housework.

But that theory doesn’t entirely hold water – it’s clear that even when women are better educated than their partners, they’re still likely to bear the heaviest burden when it comes to domestic labour.

Similarly, it’s been suggested that domestic work is divided according to time available – so when a male partner works longer hours, the female does more housework. But again, the reverse doesn’t hold true and women who work more hours outside the home still do more housework too.

Longitudinal study

We used the UK Household Longitudinal Study, which has surveyed around 40,000 households since 2010, to examine a number of hypotheses about why greater workplace equality hasn’t been matched by a more equitable division of labour at home.

Does a shared belief in equality make a difference? As men are often asked, in the modern world, to do more domestic labour, are their beliefs a driving factor? What is the role of education, if any, in how couples divide up these tasks? If one partner is resistant to sharing the work, is the other empowered by having a higher level of education?

Using opposite-sex couples in the study who were aged 16-65 and had answered the relevant questions, gave us a sample of 8,513 couples. We looked at four types of work to give us a full picture of the labour those couples did: housework, paid employment, childcare and adult care – for instance, caring for an older relative.We used a technique that allowed us to see what groups emerged from the data to see how contemporary British couples share or divide these different types of work.

We also categorized our couples according to their answers to a series of ideological questions – were they both similarly traditional, egalitarian or middling, or was one partner more egalitarian while the other was more traditional?

Education levels

Then we looked at their levels of education – were both equally educated, was the woman more highly educated or was the man more highly educated?

Very few of the couples shared work equally. In just six per cent of couples, the woman was the main earner while domestic tasks were shared quite evenly. These women were likely to be more highly-educated than their partners. In a further one per cent of couples  the man remained at home and did more than 20 hours’ domestic labour. Even in those cases, around two thirds of the women also did some domestic work.

However, these stay-at-home men were quite likely to be caring for an adult – four out of ten of them provided more than 20 hours’ care per week. Only 30 per cent of female-earner couples had children under 16 living at home, and of those just a quarter of men had the main responsibility for childcare. Men in this group did more housework than in some other groups, but they still did less than their partners.

Almost half (49 per cent) of couples were dual-earner couples in which both members of the couple tended to be employed full-time but these couples were less likely than traditional couples to have children at home.

Traditional divisions of labour

About 30 per cent of couples were traditional in the division of work with men working full-time and women not employed or working short hours. These couples tended to have dependent children at home and women in this couples did large amounts of housework, and in a small minority of women in these couples doing over 20 hours of housework per week.

A small group of couples (two per cent) also emerged in which women worked part-time and men worked very long hours at 60 hours per week or more. These women had more responsibility for care, and more for housework.

The third most common group, at 13 per cent, was a slightly older group of couples in their fifties or early sixties, in which neither were working full-time and there was little or no care responsibility. Women in these couples did relatively high levels of housework, suggesting that these couples may have previously followed a traditional gender division of work.

Those couples who didn’t have shared egalitarian beliefs – either both had traditional views or one did but the other didn’t – were more likely to fall into a more traditional work pattern.

What about education?

Men who were better-educated than their partners were more likely to fall into the traditional working patterns, and men with lower educational qualifications than their partners were more likely to stay at home. And these traditional patterns were even more likely to pertain when the man was more highly-educated and both shared traditional views.

So, education makes a difference, and so does a shared ideology. But it is important to note that very few men, in any category, did longer hours of domestic work than their female partner. So when it comes to housework and caring, gender equality remains rare and gender norms remain strong. 

Our beliefs may form a starting point for shaping our behavior, but that’s only a starting point, and not a solution. The ‘bold’ 50 minutes for 50 percent suggestion in the State of the World’s Fathers report, certainly seems to be grabbing the bull by the horns and, like our research, points clearly to the need for urgent change in terms of who does the daily care work in our homes. That is if we genuinely want a significant shift in power relations between men and women and to bring about gender equality.

Gender divisions of paid and unpaid work in contemporary UK couples is research by Anne McMunn, Lauren Webb, Elizabeth Webb and Amanda Sacker is published in the journal, Work, Employment and Society.

 

Is working flexibly good for your health?

Flexible working is considered good practice – and in England, most workers have the right to apply to work flexibly after they’ve been in their job six months. But what do we know about the benefits? A new study by Tarani Chandola and colleagues used biological measures to look at differences in stress markers among workers with reduced hours and those without.

In recent years many employees have been able to alter their work patterns to fit in with childcare and other responsibilities. Typically, this can mean working part-time, job-sharing, only working during school term-times or working from home some of the time.

It’s assumed this should help to relieve stress. But until now, we didn’t know whether this was necessarily the case. After all, there could be down-sides – for example working at home can mean a blurring of the boundaries between work and family time, part-time working can be a barrier to promotion and job-sharing can bring its own tensions.

Until recently we had to rely on workers’ own reports of how they felt in order to judge this interplay between work, family life and stress. But now a number of social surveys have begun collecting samples which allow us to measure biological changes which can indicate stress, too.

This is known as ‘allostatic load’ – when we’re repeatedly subjected to stress or trauma, this can lead to chronically heightened levels of stress hormones. And that is associated with all sorts of long-term health problems, such as heart disease, type-2 diabetes and depression.

We were able to use data from participants in the Understanding Society study, which began in 2009 and which follows more than 60,000 adults in 40,000 households. As well as responding to detailed questionnaires, many of them have been visited by nurses who have taken physical measurements and blood samples.

Blood-based markers

As well as blood-based markers such as insulin growth factor 1 and cholesterol, their pulse rate, blood pressure and waist-to height ratio were also measured.

After taking out those who weren’t employed, who didn’t have the nurse visits or for whom some measurements were missing, we had a sample of a little over 6,000 people.

All those people had been asked whether flexible working arrangements were available at their workplace, how many hours they worked and whether they were the primary carer for their children.

We categorised working hours into three groups, with different levels for men and women because they tend to have very different working patterns. So women were grouped into those working less than 24 hours per week, more than 25 hours and more than 37 hours; while men were grouped into those working less than 37 hours, 37-40 hours and more than 40 hours.

Unsurprisingly, we found more women than men had made use of flexible working  arrangements – almost no men in our sample were the main carers for two or more children.

Chronic stress

There were particularly high levels of biological chronic stress markers among women with childcare responsibilities who worked more than 37 hours per week. Those with similar childcare responsibilities but working fewer than 25 hours per week didn’t have any measurable effect on their stress levels.

Both men and women who had access to, and made use of, reduced-hours flexible working had lower levels of biological stress markers than those who didn’t have flexible working.

We found these types of reduced-hours arrangement were more common among those in lower-paid occupations, especially among men, and among older workers of both genders.

Other types of flexible working arrangements, such as working from home, were more common among those from more advantaged social groups. But we didn’t find any association between these types of working and lowered levels of stress.

So, what has our study told us? We’ve learned a good deal about the complex relationships between social and biological factors in our lives. And, crucially for policymakers, we can see that it’s particularly important for women with childcare responsibilities to be able to access shorter working hours when they need to. For employers, this isn’t just a matter of logistics and of ensuring a stable and happy workforce – it’s also a major factor in ensuring that workers live longer and healthier lives.

Are Flexible Work Arrangements Associated with Lower Levels of Chronic Stress-Related Biomarkers? A Study of 6025 Employees in the UK Household Longitudinal Study, is research by Tarani Chandola (University of Manchester and UCL), Cara Booker, Meena Kumari and Michaela Benzeval (University of Essex) and is published in Sociology.

Would reducing social inequality lead to more years of healthy life?

Across Europe, there’s good news for older people – life expectancy is on the rise and levels of disability among older people are falling. But there are concerns that a longer life may not be a better life for all. So who benefits from increased life expectancy?  Jenny Head and colleagues from the IDEAR network find those with a higher occupational status can expect the greatest number of years of healthy, disease-free life.

We know from lots of studies that there are big differences in life expectancy between different social groups. And we know that those in higher social positions tend to benefit more from that rise in healthy life expectancy.

But, given that many governments expect people to extend their working lives, we specifically need to know about the different expectations of people in different occupational positions – which is slightly different.

Together with colleagues in the IDEAR networK, we looked at what those from different occupational backgrounds might expect in later life – to be precise, how many years with good health can they expect to enjoy between the ages of 50 and 75?

The data came from four cohort studies in England, Finland, France and Sweden.

We were able to look at data from 9,213 people in the English Longitudinal Study of Ageing from 2002 onwards. We also had information on 42,978 people who took part in the Finnish Public Sector study between 1997 and 2013. In France, we used the GAZEL Cohort Study, which gathered information from 18,263 people working for the national utility company from 1989 onwards. And in Sweden, we looked at a sample of 8,186 people who responded to the Swedish Longitudinal Occupational Survey of Health between 2003 and 2014.

Health measures

We used two health measures: whether participants rated their own health as good or poor, and whether they had ever been diagnosed with heart disease, stroke, chronic lung disease, cancer or diabetes.

In all the cohorts, people in lower occupational positions could expect fewer years of life than those in higher occupational positions – and they could expect to spend fewer of those remaining years in good health.

So in England, both men and women in high-grade occupations could expect more than four years’ extra healthy life when compared with men and women in lower-grade occupations. In Finland that gap was wider, with those in high-grade jobs expecting at least six and a half years more good health. In France the difference was around two and a half years, while Sweden had the smallest gap of a little more than two years.

This pattern was consistent across the four countries and for both men and women. There were also socioeconomic inequalities in chronic disease-free life expectancy, although these differences were less marked than for self-rated health.

Better understanding

Why does this matter? A better understanding of the future health of older people is crucial to policy-makers because it affects public expenditure on income, health and long-term care. It also matters because governments want to extend working lives and increase State Pension ages, and in order to do that they need older workers to stay healthy.

Our results indicate that those in lower socioeconomic positions may be doubly disadvantaged because they have worse health but may also need to work longer for financial reasons. To achieve extended working lives for all, policy-makers will need to find ways of reducing those social class differences in health expectancies.

Socioeconomic differences in healthy and disease-free life expectancy between ages 50 and 75: a multi-cohort study, by  Jenny Head, Holendro Singh Chungkham , Martin Hyde, Paola Zaninotto, Kristina Alexanderson, Sari Stenholm, Paula Salo, Mika Kivimäki, Marcel Goldberg, Marie Zins, Jussi Vahtera and Hugo Westerlund, is published in the European Journal of Public Health.