Tag Archives: Flexible working

Frailty: what is the connection with our working lives?

People are living longer, and the number of over-65s is expected to reach around one in four of the UK population by 2050. But is retirement a golden age, or will we be dogged by poor health? Wentian Lu from University College London and colleagues investigated how our working pattern throughout our lives affects our health after we retire, and found interesting differences between men and women.

Government policies are focused on extending our working lives, and record numbers of people are now working beyond state pension age. But what effect is it having on our health?

The UK government’s former older workers champion, and pensions expert, Dr Ros Altmann argues that raising the state pension age is a blunt instrument for managing old-age support, which could compound existing social and health inequalities.

With people being expected to work for longer, it is critical to understand whether and how people’s working lives affect their later life health.

A recent study led by colleague Dr Giorgio Di Gessa found no significant health benefits from working beyond state pension age, once social background, previous health and employment histories were taken into account.

Our investigation was the first in England to focus on the impact of earlier working patterns on health in later life.

We used information on more than 1,600 men and nearly 2,800 women from the English Longitudinal Study of Ageing. Health-related information on a range of things such as chronic conditions, pain, depression, heart disease, falls, fractures and joint replacement was used to develop a frailty index.

Using detailed work histories between the ages of 16 and 64 for men (16 and 59 for women), they were divided into groups which ranged from ‘full-time employment throughout’ to ‘unemployed throughout’. For men, we considered those who left work early, at either 60 or 49 years, and those who started work late (e.g because they went to University or spent time gaining other qualifications) and retired at 60.

For women’s employment histories, we also took account of part-time working, long and short career breaks, family care, and those who only had occasional work and retired early.

Frailty over time

The study confirmed that frailty increased with age, accelerating after 65 for women and 70 for men.

The findings showed that women who took a short break for family care and then worked part-time until they were 59 had better health at retirement age than those who were mostly in full-time work. Experiencing long career breaks or only working occasionally also appeared to be more detrimental for women’s health. This finding supports the importance of work-life balance for women’s health in later life.

Women who returned to work part-time after a short career break were healthier than those who went from family care to full-time work. If further studies confirm this result, it would indicate that working part-time while their children are young can have long-term positive benefits for women’s health. The key to maintaining the long-term health of today’s generation of working mothers will be to promote flexible working policies, such as flexible start and finish times, allowing women to balance work and childcare.

Consistent with previous studies, our investigation found that women who have never worked tend to have poorer health than those who worked full-time until the age of 60. What was more surprising was that women who never worked experienced a slower decline in their health beyond the age of 60, even when social background and health-affecting behaviours such as smoking and drinking were taken into account.

Early retirement

Men who retired early at either 49 or 60 had poorer health than those who worked until they were 65. However, leaving paid employment before the age of 65 slowed down the progress of poor health in later life.

This supports the findings of previous studies which show that the burden of ill-health is substantially relieved by early retirement. With Government policies encouraging older people to work longer, our research lends further weight to concerns that this may not be good for those already suffering poor health.

Another unexpected finding was that men who started working later in life and retired at around 60, who tended to be those more highly educated and with greater social advantage, actually experienced more rapid declines in health after the age of 65 than those who worked full-time from an earlier age and retired early. This was a small group, so further research is needed to explore this in more depth.

Despite limitations imposed by some of our employment history groups being quite small, as well as possible biases coming from participants’ subjective reporting of health issues, our findings offer important pointers for developing effective strategies to improve health for older people in the UK.

If, as Dr Altmann suggests, the government could replace the blunt instrument of raising state pension age with more finely-tuned policies, allowing those who can and want to extend their working lives to do so in a flexible way, this would be fairer and give the most vulnerable a better chance of enjoying a healthy retirement.

Further information

Relationship between employment histories and frailty trajectories in later life: evidence from the English Longitudinal Study of Ageing is research by Wentian Lu, Rebecca Benson and Amanda Sacker of University College London, Karen Glaser and Laurie Corna of King’s College London, Loretta Platts of Stockholm University, Diana Worts and Peggy McDonough of the University of Toronto, Giorgio Di Gessa from the London School of Economics and Political Science, and Debora Price of the University of Manchester. It is published in the Journal of Epidemiology & Community Health.

 

Work and family conflict: who is at risk?

Juggling the demands of work and family can create conflict and this can play out differently for men and women. But what other factors are at play? Do things like the sort of job we do and the levels of control we feel we have at work and at home matter too? It’s a subject of keen interest not just to individuals, but also employers and Government, who are being urged to provide more and better support for working parents. Dr Helena Falkenberg from Stockholm University and a team of colleagues have been investigating and find that these other factors do indeed matter, especially for women in senior level jobs.

Being in a job we enjoy and having a family are sources of great satisfaction, but also of conflicting demands. From organising childcare and sharing the housework to getting that all important report done on time and preparing for a big presentation, being a working parent can be tough at times.

Maybe there’s a special breakfast meeting that means mum or dad can’t take the kids to school or perhaps one of the children is suddenly unwell and decisions need to be taken around which parent will take time off. Work gets in the way of family life and family matters can prevent us getting on with our work.

A recent report from the Chartered Institute of Professional Development (CIPD) called for a step change in support for working parents from UK Government and employers, claiming initiatives such as Shared Parental Leave and free childcare policies are not hitting the mark, despite being well intentioned.

In this research, rather than looking simply at how and to what extent men and women are conflicted over work and family, we try to pinpoint more clearly other aspects of our lives that might be linked with conflict. In that we way, we can identify more clearly the sorts of individuals at greatest risk which in turn might help employers and policymakers identify and target support at specific groups.

This study investigated the links between gender and socioeconomic status (specifically in this case the type of job people did) and levels of conflict. It also examined how levels of control at home and work increased or reduced conflict.

The findings suggest that if you are a woman or have a higher level job, you are most likely to experience conflict between work and family life. In addition, the less in control you feel at work and at home, the greater that conflict is for both men and women.

Our study highlights the need to make it easier for higher status employees to combine work and family, especially women, and to increase the levels of control at work and at home to help individuals manage work and family successfully.

Civil servant data

We used information from the Whitehall II study of nearly 3,500 British civil servants (2,657 men and 827 women) in the 1990s. They were grouped into three different socioeconomic status levels

  • Senior administrative
  • Executive/professional
  • Clerical/support

Participants in the study were asked whether and to what extent their work interfered with family life. For example did work commitments reduce the amount of time they could spend with the family. Did their job involve a lot of travel away from home and did it make them irritable at home or leave them lacking the energy needed to do home and family related things.

When it came to how family got in the way of work, they were asked if family matters distracted them from getting on with work, prevent them from getting enough sleep to be do their job well and having enough time to themselves.

To dig deeper into the question of how in control they felt at work and at home, they were asked a range of questions including much say they had in decisions at work, how much choice about what they did and how much flexibility there was. For control at home they were asked to what extent they agreed or disagreed with the statement: “At home, I feel I have control over what happens in most situations.”

When we took into account factors such as part-time work, whether the individuals were married, had children or other caring responsibilities, women reported more conflict between work and family than men. When we added in to the analysis how much control over work and home life participants felt they had, the difference between men and women was even more pronounced.

Having a more senior position was also a key factor for both sexes, but especially for women. The small number of women at high grades in the civil service and other areas of the labour market appears, to some extent, to reflect the difficulties for women in high positions to combine work and family. Notably in our study sample, more than half of the women with senior level jobs did not have children.

When it came to how family interfered with work, once again women fared worse than men, with women having more than twice the risk of their family life interfering with their work life. Of the women, those in higher positions fared worst of all. The type of job the men did in the study did not make a difference to the levels of interference.

Being in control

Participants who reported low levels of control at work were most likely to say that work interfered with family life, indicating that more control and flexibility at work eases the transition between work and family. There was less of a link between low levels of control at work and those reporting family interference with work. However the interaction between control at work and the influences of socioeconomic status and gender needs further research to draw significant conclusions.

Low levels of control at home also contributed to a markedly higher risk of work-family and family-work conflict. This seemed to be equally important for women and men no matter what their position at work. To develop effective policies on work-family balance, the home sphere will need further research.

One limitation of our study is that it was conducted among white-collar British civil servants, and the findings may differ among other working populations and, particularly, in different countries with different social security systems. Information was also collected some years ago.

However, we found clear evidence that women experienced more interference between work and family and vice versa than men, especially women in senior positions. This is important as it might influence their career choices and their health over time.

We hope this research and further work in this area will help employers and Government to get a more nuanced picture of what factors are at play when it comes to the issues facing working parents, and ultimately develop initiatives and approaches that can reduce the conflict in a way that helps them to thrive at work and at home.

Further information

Do gender and socioeconomic status matter when combining work and family: Could control at work and at home help? Results from the Whitehall II study is research by Helena Falkenberg and Petra Lindfors of Stockholm University, Tarani Chandola of the University of Manchester and the ESRC International Centre for Lifecourse Studies, and Jenny Head of University College London. It is published in the journal Economic and Industrial Democracy.

Out of work again? The psychological impacts of repeated unemployment

Being unemployed is bad for our mental well-being, but if we lose our job more than once does the psychological blow lessen in some way? Researchers Cara Booker from the University of Essex and Amanda Sacker at the International Centre for Lifecourse Studies at UCL used the long-running British Household Panel Survey to examine the psychological well-being of people who have repeatedly lost their jobs. Their findings show that our employment history makes a difference and could have implications for welfare to work initiatives from Governments looking to get people back to work.

Continuous employment may be what is best for us, but of course life is not always that straightforward and, at any given time, a significant proportion of the population will be out of work. This could be because we choose to take time out to undertake training or to have a family. We may fall ill or be made redundant.

The world of work is also becoming more flexible. Fewer people are staying with the same firm for long periods of time and more people are moving from contract to contract or job to job, sometimes with spells of unemployment in between.

At the same time, the Government wants to get more people off benefits and into work and is looking to make its Work Programme more effective.

Using 17 years of data collected from the participants in the British Household Panel Survey (1991-2008), we looked at any individual who had reported at least one spell of unemployment. Of these 1,642 participants, 82 per cent were unemployed once, 15 per cent twice and 3 per cent three or more times.

Mental health score

Participants were asked a range of questions about their mental health and answers to these were used to allot a score with 0-11 indicating good psychological health and 12 or more indicating stress or anxiety that could lead to ill health. The time periods before and after a spell of unemployment were also taken into account because job loss isn’t generally something that happens suddenly and there can be weeks or months building up to it.

Looking at the group as a whole, we found their psychological well-being was generally poorer during all spells of unemployment compared with when they were not unemployed, but there was no evidence of a lowering or increasing of the effect from one spell of unemployment to the next.

When we dug deeper into participants’ prior work history, however, we saw some differences between those people who had previously been ‘economically inactive’ (voluntarily not working e.g. to look after family or study) and those who had been working.

Those who prior to being employed had been ‘voluntarily’ not working suffered poorer psychological well-being after they went on to lose their job but became notably worse in the third spell of unemployment.

The previously employed group’s psychological well-being also took a knock after losing a job once and then again, but, by the third time there was no change, a possible indication that the individual is somehow adapting or getting used to dealing with the ‘shock’ of becoming unemployed.

When we compared levels of psychological well-being between these two groups, they were notably lower among the previously employed at unemployment spells one and two, but this was reversed at spell three.

Employment history matters

So only when we took into consideration being economically inactive as opposed to employed, did a slightly clearer picture emerge around this question of whether people adapt to the ‘shock’ of unemployment, with those previously employed seeming to adapt and those previously economically inactive becoming increasingly sensitive to it. These findings were given further weight when we looked at retrospective employment histories before the BHPS began.

One explanation for this is that those who come from an employed background tend to find work again after each unemployment spell they experience, so they become less anxious about finding another job. The economically inactive, meanwhile, seem to find it harder to enter and re-enter the job market which could account for increased anxiety with more attempts to sign up as ‘unemployed and seeking work’.

Household income also played a role with those who were economically inactive on higher than average incomes experiencing worse psychological well-being than their less off counterparts when making an unsuccessful attempt to enter employment.

In its recent Welfare-to-Work report, the Work and Pensions Committee pointed out that key to the programme’s success was providing unemployed people with “the right help at the right time” and a better understanding of the barriers and characteristics that prevent a swift return to work. A better understanding of the impacts of repeated spells of unemployment on people’s well-being would seem to resonate here.

It is also clear that good quality, secure employment opportunities with long term prospects are key to people’s health and happiness.

Psychological well-being and reactions to multiple unemployment events: adaptation or sensitisation? is research by Cara Booker and Amanda Sacker and is publishes in the Journal of Epidemiology and Community Health

Photo credit: Kathryn Decker

 

Are permanently sick people less sick nowadays?

Brexit aside, there have few topics more hotly contested in recently years than who should get incapacity benefits. The steady rise in the incapacity benefits bill over several decades led some to question whether greater numbers of people could actually be sick and whether this group is actually healthier, with less serious health problems, than had been the case in decades past. But what does research evidence tell us? Bola Akinwale from Public Health England and colleagues at the ESRC International Centre for Lifecourse Studies have looked at 30 years’ worth of data to see.

In the last 30 years of the 20th century, life expectancy for those aged 65 increased more than it had in the previous 70 years. A job market that had been almost completely dominated by men became dramatically more diverse. By the turn of the century, very few men aged 60-64 were in paid work, although that number has since increased.

On the face of it, many of these changes represent good news, but they have also created new challenges around funding pensions and how to keep increasing numbers of older people healthy and active for longer.

Our research looked at the proportions of men and women around State Pension Age who were employed, unemployed, permanently sick (those we might expect to claim incapacity benefits) or retired. We went on to look at their health immediately after retirement age to see if they had died prematurely or had a limiting long-term illness or disability.

When we compared the labour market positions of 60-64 year-old men in 1971 compared with 2001, we saw some big changes:

  • Working – 78.4 percent v 47.5 percent
  • Retired – 7.2 percent v 24.7 percent
  • Permanently sick – 9 percent v 19.7 percent

By 2001, women were almost as likely as men to describe themselves as retired after State Pension Age and 12.4 percent of 55-59 year-old women described themselves as permanently sick in 2001 compared with 3.4 percent back in 1971.

So we see the proportions of permanently sick men doubling over 30 years and quadrupling for women.

Across the same time frame, the risk of dying just before State Pension Age decreased substantially – by more than 60 percent for men and by more than 50 percent for women, irrespective of whether they are in work or permanently sick. In other words, both groups benefited equally from these changes – staying healthier and living longer than their counterparts 30 years previously.

Are sick people less sick nowadays?

 The answer is no and yes – it depends on the comparator.

To try to get to the bottom of this idea that people who are permanently sick are less sick than their historical predecessors, we compared the likelihood of them dying prematurely with that of their working peers.

On the one hand, if they were less sick, we would expect to see the gap between the chances of dying prematurely for these two groups get smaller over the 30-year period. We don’t see that.

Permanently sick men aged 65-69 were three times more likely to die prematurely than their working peers in 2001 and this was an increase on the 1971 figure. For women, the figure was between four and five times over the period we looked at.

On the other hand, it’s clear that this 30 year period brought about some remarkable changes in the working lives and general health of older people, including among permanently sick group. Their life expectancy has increased in line with other people of their age.

But despite these improvements in life expectancy among permanently sick people, compared with employed people their likelihood of dying has, if anything, slightly increased and certainly not decreased.

So, taken together, our research does not support the argument that the permanently sick have less serious health conditions nowadays than they used to.

A key plank of the Government’s policies for people who are unable to work due to illness is to try to support them back to work wherever possible. Our research shows that achieving this aim, requires careful consideration of the types of jobs and working environments that might be suitable for people with chronic illnesses.

If we don’t create enough jobs that older people with chronic illness can sustain and thrive in, life expectancy gaps between those in work and those who leave the workforce prematurely due to ill-health may widen further.

Work, permanent sickness and mortality risk: a prospective cohort study of England and Wales, 1971-2006 is research by Bola Akinwale, Kevin Lynch, Richard Wiggins, Seeromanie Harding, Mel Bartley and David Blane. It made use of linked census and death records in the ONS Longitudinal Study.

Photo credit: ILO in Asia and the Pacific

Does having a rotten job in middle age leave us depressed in retirement?

People’s working conditions have been high up the news agenda recently and not just in non European parts of the world either. Understandably, considerable concern has been expressed about the impact that low paid jobs with poor and uncertain conditions have on workers’ lives. But what are the impacts of poor or stressful working conditions and job uncertainty on people’s mental health further down the line once they stop working? Morten Wahrendorf from University of Düsseldorf in Germany and colleagues at the ESRC International Centre for Lifecourse have carried out research across Europe and found that those with poor jobs and working conditions in mid life are considerably more likely to suffer with depression after they retire.

Right across Europe people are living longer – on the face of it – a good thing. Unfortunately, for many, that increased life expectancy is accompanied by extended periods of poor health or disability – both physical and mental. The consequences of this are deeply worrying for policy makers funding services to care for people, overstretched health professionals and, of course for people themselves and their families.

It’s really important, therefore, to get a better handle on what goes on in our lives before we retire that might be linked to this later poor health. If we can identify what might lie behind it, we are more likely to be able to make changes and put things in place that reduce the risk for future generations.

The research looked at the mental health of nearly 5000 men and 4000 women with an average age of around 70 in 13 European countries and then looked back at their working lives in mid life to see what picture might emerge.

Using information from the Survey of Health, Ageing and Retirement in Europe (SHARE), we looked at how stressful their job had been both physically and mentally, how well rewarded and supported they felt, whether they had been laid off or had a period of unemployment. We used a special set of questions asked in the survey to identify whether or not the participants showed signs of depression.

Physically and mentally demanding work

More then a quarter of the men and a fifth of the women reported their job had been highly physically and/or highly mentally demanding. The proportion of women who worked in low-skilled jobs was lower among women compared with men (80 per cent women, 68 per cent men).

With regard to stressful conditions at work, 15 per cent of men and 23 per cent of women said they had had low levels of control at work. 20 per cent of men and 27 per cent of women said the rewards were low and 17 per cent of men and 20 per cent of women said they received low levels of social support.

When we linked their earlier working life to their mental health in retirement, both men and women who had previously worked in mentally stressful jobs were more likely to exhibit signs of depression later on. For men, the strongest links with depression were for those who reported having jobs with a low level of control, whilst for women it was jobs with low levels of social support.

Both men and women who had worked in poor quality jobs were considerably more likely to be depressed than their peers with good jobs. Unsurprisingly, those people who had been unexpectedly laid off from a job in mid life were also more likely to be depressed later. Surprisingly, though unemployment and a fragmented career were associated with depression in men only.

The results stayed strong even after taking account of the workers’ health and social circumstances before middle age.

Clear and robust link

The research reinforces a number of studies drawing a clear and robust link between poor mental health in later life and a disadvantaged working life in middle age, whether that be in terms of working environment or job uncertainty. What’s new here though is tracing that link over people’s lifecourse from middle age into retirement. The research also shows some important and interesting distinctions between men and women.

There is a clear message here too for policy makers, business and health professionals that mid-life is a critical period where appropriate interventions and employment-related policies, such as lifelong learning programmes, through programmes increasing job security, or even mindfulness training, could bring significant benefits to individuals and society more widely, especially in the undeniable context of us all living and working longer.

Working conditions in mid-life and mental health in older ages is research by Morten Wahrendorf, David Blane, Mel Bartley, Nico Dragano and Johanes Siegrist and is published in Advances in Life Course Research.

Photo credit: World Bank

 

 

A question of inflammation

Inflammation can be good and bad for us. Find out more in this presentation from researcher Rebecca Lacey, who uses inflammatory markers in mid life to look at whether the way in which we combine our work and family lives early on affects our health later on.

The research,  presented at an ESRC International Centre for Lifecourse Studies policy seminar, concludes that homemakers and people who have children early, particularly teen parents, are at greater risk of poor health in mid life and recommends increased support and opportunities for young parents.

Listen to Rebecca’s presentation and view the slides below.

Work, family and health – a question of inflammation? from Chris Garrington on Vimeo.

Photo credit: Fixers