Tag Archives: Mental health

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

 

 

Can unemployment kill – Podcast

Our first blog showcased recent research from the team at ESRC International Centre for Lifecourse Studies about the links between long term unemployment and stress markers linked to killer diseases. If you were interested in that, you can also listen on Soundcloud to researcher Amanda Hughes discussing the research for the ICLS Podcast.

Can unemployment kill?

At the height of the recent recession around 2.7 million people were unemployed, and youth unemployment accounted for nearly 40 per cent of that total. Given growing evidence that unemployment is linked to long term illness and increased mortality, we can expect health implications for those affected. In a week when unemployment rose for the first time in over a year, Amanda Hughes presents new evidence from the ESRC International Centre for Lifecourse Studies on the links between unemployment and killer diseases such as heart disease.

In 1984 a study was published which had linked census data to mortality records and found that men unemployed in the week of the 1971 census were 36 per cent more likely to have since died than men of the same age who had been in work. Accounting for differences in social background only explained part of the excess, raising the question: can unemployment kill, and if so how?

That unemployment might damage health was not a new idea. Marie Jahoda’s research on unemployment in the 1930s had shown that the non-financial benefits of work, such as defining aspects of status and identity and providing regular social contact, are for many people crucial to mental wellbeing. And since job loss usually brings a sharp drop in income, it is intuitive that unemployment could affect physical health by reducing quality of diet or opportunities for exercise.

But there tends to be more scepticism as to whether serious physical illness or mortality could be causally influenced by the undoubtedly stressful experience of unemployment. Might those unemployed men have developed serious illness when employed, lost their jobs as a result, and then died from their illness? Or might their increased mortality simply be caused by unemployed people smoking and drinking more? In neither case could it be claimed that unemployment itself has caused any deaths.

New approach

Since the 1980s, the tools available to scientists researching the health impacts of social conditions have moved on considerably. One new approach involves molecules called ‘inflammatory markers’ which circulate in the bloodstream and appear to be influenced by stressful experiences.

Elevated concentrations have been found in the recently bereaved and caregivers; inflammatory markers are also typically higher for people of disadvantaged socioeconomic position as measured by income or occupational social class. Crucially, raised concentrations of these molecules are linked to atherosclerosis and predict heart disease, presenting a possible causal pathway between a stressful social environment and increased mortality.

It was for this reason that we wanted to see if two inflammatory markers – C-reactive protein and fibrinogen – were elevated in jobseekers compared to employed counterparts.

We used the Health Survey for England and Scottish Health Survey, annual government surveys used to track changes in the health of both countries’ populations. To isolate elevations in these molecules due to unemployment-related stress, we considered a number of additional factors beyond participants’ age and gender.

To rule out elevations due to serious illness predating job loss, we considered whether participants had a long-term illness of any type. To rule out elevations caused by disadvantaged socioeconomic position more generally, we took into account housing tenure and occupational social class from current or most recent job.

Finally, to test whether elevations might be explained by worse health-related behaviours of jobseekers, we took into account participants’ smoking, alcohol consumption and body mass index.

Stress markers

In our sample of over 23,000 men and women of working age, unemployed people had elevated circulating levels of both molecules even after consideration of these factors. These differences were moreover clinically relevant, since unemployed participants were 40 per cent more likely to have C-reactive protein over 3mg/L, the level at which cardiovascular risk becomes elevated.

Effects were not uniform across the population. Firstly, older jobseekers (48-64) were more affected than younger jobseekers. This might indicate that unemployment is more stressful for jobseekers facing age discrimination, or equipped with outdated skills.

Since older jobseekers will have accumulated more unemployment over their lifetimes than younger counterparts, it could alternatively indicate that long-term or repeated unemployment is especially damaging to this aspect of health.

Secondly, we found substantial differences in results by country, with much greater elevations in both molecules for jobseekers in Scotland than in England. Data from the Labour Force Survey and the British Household Panel Study show that during the years of data collection (1998-2010) unemployment was higher in Scotland than England, and unemployment spells on average longer, which suggests two possible explanations.

Firstly, the jobseekers in Scotland may have been unemployed for longer, or had more recent unemployment spells, than English counterparts. Secondly, unemployment could be more stressful in times and places where the background rate is higher, since jobseekers will rationally perceive their prospects for re-employment as worse.

Since these surveys only collect information from people at one point in time, it was not possible in this analysis to investigate effects in the context of people’s employment histories. But unpicking these explanations will be crucial if we are to better understand the conditions under which unemployment is most likely to damage health, and which groups are most at risk.

Crucially, given last week’s news of a 21,000 rise in unemployment for the first time in a year  to 1.7 million people, policy makers interested in the long term health of the population should not divert their gaze from its wider consequences.

Photo credit: Kate Hiscock

Further information

Amanda Hughes is a Senior Research Officer at the Institute for Social and Economic Research at the University of Essex.

Elevated inflammatory biomarkers during unemployment: modification by age and country in the UK is research by Amanda Hughes, Anne McMunn, Mel Bartley and Meena Kumari and is published in the Journal of Epidemiology and Community Health.

References

Unemployment and mortality in the OPCS Longitudinal study is research by K.A Moser, A.J Fox, and D.R. Jones, and is published in the Lancet.

Unemployment durations: evidence from the British Household Panel Survey is research by K. Long and is published in Economic & Labour Market Review.