Tag Archives: Stress

Having any job at all is better than being unemployed, right?

“Bad work just doesn’t fit in 2017!” Those are the words of Matthew Taylor, head of the Government’s recent review of modern work practices, who has called on politicians to make “all work good.” In an interview with the BBC, Mr Taylor, said that, as well as being bad for productivity and the economy, poor quality jobs were bad for people’s health and well-being. Recent research from Tarani Chandola from the University of Manchester has added further weight to those claims, finding that unemployed people who move into poor quality work have worse health than their peers who remain out of work. He explains more about the research findings and how they challenge the idea that having any job is good for your health.

There is considerable evidence to show that being out of work isn’t good for our health and that being in work can bring us a range of benefits, not just financial. It follows, then, that a move out of unemployment and into work is likely to be good for us, but does that hold true if the job we go into is a bad one?

Using rich social, economic and health data from the UK Household Longitudinal Study (UKHLS), our research examined the stress levels of a group of unemployed people aged 30-75, some of whom moved into poor quality jobs, some into good jobs and some who remained unemployed.

We also looked to see if any other factors, including their health at the outset of our study, had any bearing on the likelihood of them moving into a poor or good quality job.

Twelve biomarkers

As well as physical measurements such as height, weight and blood pressure, and self-reported information on their physical and mental health, some participants in the study gave blood samples. These could be tested for a range of markers, high levels of which might indicate diabetes, heart or kidney disease, acute or chronic stress. In total, we had 12 separate biomarkers, providing us with a comprehensive picture of participants’ health and an overall measurement of their stress, something referred to as their allostatic load.

How much people earned, how secure their job was and their working environment were all considered, in order to get a sense of the quality of their employment. Participants were asked how satisfied they were at work, how anxious or worried they felt about their job, how much control they had at work and whether they thought they might lose their job in the coming 12 months.

The people studied were divided into four groups:

  • Remained unemployed
  • Employed in a good quality job
  • Employed in a job with one poor quality measure
  • Employed with at least two poor quality measures

Stress levels

When we looked at the stress levels of the different groups, a clear pattern emerged. Unsurprisingly, people who moved out of unemployment and into a good job had the lowest levels of stress. People who went from being unemployed to working in a bad job (with more than two poor quality job measures) had the highest stress levels. These were 1.5 times higher than for those people who remained unemployed.

We took into consideration a host of other factors that might have had some role in propelling an unemployed person into a good or bad job, but even when we looked at their health at the outset of the study, this did not really play a role, other than to note that the people in better health moved into both good and bad jobs. In other words it wasn’t simply that people already in poor health were moving into the worse jobs.

Although numbers for this research were relatively small, the methods and analysis were extremely robust and we can, with some confidence, challenge the widespread belief that any employment, even poor quality work, is better for our health and wellbeing than being unemployed.

The findings serve to illuminate research published by the RSA and Populus recently, showing that three out of four people think we should do more as a country to improve the quality of work. Even more telling was the contrast between the over two thirds who think we can make all work fair and decent, and the less than one in ten who think this is already the case.

Making good work matter

Mr Taylor makes the case that “good work matters” and the RSA’s social media campaign #GoodWorkIs is a laudable effort to engage the wider public in a discussion about what good work looks like.

However, he, like many others, has said that the “worst work status for health is unemployment”. Our research shows that’s not necessarily the case, and our findings, together with more research in this area, should be considered carefully as strategies are hopefully developed to make his call to “make all work good” a reality not a pipedream, especially in the current political climate.

Re-employment, job quality, health and allostatic load biomarkers: Prospective evidence from the UK Household Longitudinal Study is research by Tarani Chandola and Nan Zhang and is published in the International Journal of Epidemiology.

 

Why retirement might not be as stress-free as you hoped!

Ahhhh retirement: finally time to relax, enjoy life, unwind and feel less stressed. That is certainly how many people will be expecting or hoping that their retirement will pan out when it happens. But research by Tarani Chandola from the University of Manchester and colleagues at UCL and the University of Essex, shows that whilst dreams of a less stressful life in retirement may come true for those in higher status jobs, they are less likely to do so for those in low status occupations. Here he explains the research, which uses innovative methods to see whether retirement really is the stress buster many of us hope it will be.

We have known for some time that people from poorer backgrounds in low status jobs generally have poorer health across their lives and tend to suffer from greater levels of stress. Those health inequalities widen as people get older, but it had been assumed that retirement might see a closing of the gap, because poorer workers have higher levels of work stress, but this appears not to be the case, something that researchers have found hard to explain.

As most countries are now raising retirement age and, with it, the age at which workers can collect their State Pension, it is really important that we understand the impact these policies might have on the health and wellbeing of employees, particularly those in disadvantaged working conditions.

In this research, rather than just making use of self-reported health information from workers, we wanted to get right under their skin to look at what signs of stress there were in their bodies in the run up to and after retirement. We wanted to compare the stress levels of those who had just retired to those still in work and we also wanted to compare the stress levels of workers in high and low grade jobs.

We were able to do this by looking at the changing levels of a stress related hormone called cortisol.

Whitehall Study

Our information came from The Whitehall Study, which has tracked the working lives of thousands of UK civil servants since the 1980s. As well as being a good fit for the research because of the type of information available, using a longitudinal survey like this enabled us to observe the same people over this important period of in their lives.

We focused on just over 1000 of the study’s participants who were aged around 60 and who, as part of the Study, provided a series of saliva samples across a day. Using these saliva samples, we could measure their changing levels of cortisol over the day. Waking up in the morning results in the release of cortisol, which declines to almost negligible levels by bedtime. The steeper the declines in a person’s cortisol measurement across the day, the less stressed they were. People with relatively higher levels of cortisol at bedtime are more stressed and have a flatter rate of decline of cortisol.

Their employment grade was categorised as ‘high’, middle or ‘low’ according to the civil service banding system.

Civil servants who were employed in the lowest status jobs had the highest levels of stress, whilst those in the highest status jobs were the least stressed. We could also see that, after retirement, when we might have expected biological stress levels to fall for all the workers, this was only the case for those in the top jobs. Lower grade workers who had just retired were just as stressed as their peers who were still working.

Stresses and strains of working life

Worryingly, far from being a time when the stresses and strains of working life melt away, retirement seems to bring little or no relief for those in lower grade occupations. It seems the health inequalities observed between those in high and low grade jobs are magnified not only as workers get older, but even in retirement, when we might think the opposite would occur. In other words, at a time when the gap might be expected to close, in fact it widens.

It’s important to note that we took a wide range of other factors into account when we looked at the lives of the people in the study, including their broader health, whether they had a serious life-limiting illness, whether they were married etc., but our results remained strong, giving us considerable confidence in our findings.

Of course, there can be many different factors at play as we prepare to retire. Workers who retire from low status jobs often face financial and other pressures, whilst their better paid peers enjoy good pensions and have the resources to engage in leisure and social activities.

Another key point to make is that if this is the picture for people working in the civil service, where working conditions are considered very good and certainly a great deal better than most other employment areas, things are likely to be worse in other types of job where working conditions are less favourable.

For those looking to tackle inequality and unfairness in the workplace and wider society, our findings add to a growing body of evidence of how they are magnified across the lifecourse. They serve to remind us also that if we want everyone to enjoy a relaxed, happy and fulfilled retirement, then those inequalities must be addressed early with policies that are based on solid evidence.

Retirement and Socioeconomic Differences in Diurnal Cortisol: Longitudinal Evidence From a Cohort of British Civil Servants is research by Tarani Chandola, Patrick Rouxel, Michael Marmot and Meena Kumari and is published in The Journals of Gerontology: J Gerontol B Psychol Sci Soc Sci, 2017, Vol. 00, No. 00, 1–10

Organisational change: impact on early retirement

Motivating older employees to stay working longer is seen as a key way of tackling the current pensions crisis facing many countries. Something of a fly in the ointment for those looking to address the problem is the option to take voluntary early retirement, especially where among those who are in good health and best placed to continue working. Dr Nina Breinegaard and colleagues at the University of Copenhagen have been researching the situation in Denmark and, as Nina explains here, they find that a key area of focus for employers and policymakers could be organisational change.

A whole host of things influence our decision around when to retire. These include obvious things like our finances, the state of our physical and mental health and what’s going on with our family and close friends.

Another key influence is what is happening in the workplace. A job may have become too physically demanding for example. A number of studies have shown that when a company is restructuring or downsizing, employees may feel less secure about their position. This in turn can be a catalyst for early retirement, sometimes on the grounds of ill health.

In our research, however, we wanted to try to get to the bottom of how organisational change might influence those without any health problems to retire early. We also wanted to take a close look at the combined influences of the psychological and social sides of work on that decision.

Claiming benefits

In Denmark, men and women who have paid into an early retirement benefits insurance fund can claim those benefits between the ages of 60-64 even if they are in good health. At the end of 2012, 34 per cent of women and 27 per cent of men aged 60-64 received these early retirement benefits.

We linked Denmark’s DREAM database, which collects information on all public benefit payments, with a survey collected over a two month period in 2011 from more than 28,000 public sector workers. This enabled us to look at which employees decided to take early retirement benefits and whether changes at work were linked to that decision.

All this information was then linked to administrative data to take a range of social and economic background factors into account.

We ended up with a group of 3254 employees aged 60-64 who were entitled to early retirement benefits. Details of any changes at their workplace: a change of manager, a merging or demerging of departments or workgroups, moving to a different office or having a new base, were collected independently from current or previous managers.

They also rated the quality of their work environment e.g. how good their managers were at leading, how positive relationships were with other colleagues and how fairly and well concerns and conflicts were dealt with (organisational justice). The answers to all these questions were then used to create overall scores for each employee’s work environment.

Follow-up

When we followed up with our survey participants, we found that one in five women and one in seven men had taken early retirement benefits with early retirement being common in all occupational groups except for doctors and dentists.

65.1 per cent of the 2206 employees for whom we had information about all types of organisational change had experienced one or more changes. Change was most frequent among social and healthcare workers (74.9 per cent) and least frequent among laboratory technicians (46 per cent).

Employees whose workplace had undergone a change of management or a merger were much more likely to have taken early retirement than those who had not. After taking background factors including age, marital status, gender etc. into account where a change in management had occurred, the likelihood of early retirement increased even more. Adjusting for the same factors for those whose workplace had experienced a merger made no difference to the likelihood of early retirement.

Relocation was linked somewhat less closely to early retirement and the demerging of departments or workgroups had no effect at all.

On their own, poor quality work relationships and networks and low levels of organisational justice were also associated with early retirement. How well people felt they were managed had an effect only once background factors (apart from age) were taken into account. When any organisational change was factored in as well as the quality of the work environment variables, the likelihood of an employee retiring early increased further.

Organisational change matters

Taking everything into account, we can say, for the first time, and with considerable confidence, that when it comes to early retirement, organisational change makes a difference, particularly where it involves a change of management. Organisational changes on top of a work environment that is perceived to be poor compounds the likelihood of an employee retiring early.

Given that our research focuses on people who are not retiring because of poor health or disability – the very employees that organisations and policy makers want to encourage to work for longer – our findings are likely to be of considerable interest.

Key would seem to be careful consideration of the impacts of any restructuring within a business or organisation. Improving the workplace environment could also have a role in reducing the numbers of employees calling time on work before the age of 65.

The frequent occurrence of organisational change in the Danish healthcare sector is interesting in the light of medical doctors, nurses and other health and social care workers recently being identified as shortage occupations in Denmark. Managing those changes and improving the working environments of people working in these occupations could be a priority, not least because ageing populations not just in Denmark, but the world over, clearly need these groups of workers more than ever before.

Organizational change, psychosocial work environment, and non-disability early retirement: a prospective study among senior public employees
 is research by Nina Breinegaard, JH Jensen and JP Bonde and is published in the Scandinavian Journal of Work, Environment and Health.

Photo credit: Workers, Justin Lynham

Who works post State Pension Age?

Across Europe and indeed other parts of the world, we’re being told we need to work longer than in the past. The reason? We’re all living longer and pension systems everywhere are collapsing under the strain. But with age can come poorer health and reduced physical capabilities and what if doing our job is physically or mentally demanding? Raising the State Pension Age for this group of workers compared say with someone working in a less stressful job could end up creating pressure on specific disadvantaged groups, whilst favouring already advantaged groups. Morten Wahrendorf from the University of Dusseldorf and ESRC International Centre for Lifecourse Studies has been investigating.

A number of Governments across Europe have already increased the state pension age beyond 65 and are actively looking to introduce incentives and measures that they hope will get more people of working age to retire later.

Quite a lot of research has looked at what things are going on in people’s lives that might lead them to retire early from work, but far fewer questions have been asked about what might lead to someone working beyond state pension age. What sorts of jobs do they tend to do? What are their working conditions like? How do those compare with people who retire earlier?

It’s important to get a grasp of this if we are to ensure that any changes made to the pension system are fair and just and that they don’t adversely affect specific or already disadvantaged groups.

Using information on nearly 18,000 men and women aged 65 and over from 16 European countries we were able to look into this in some depth and effectively compare prior working conditions of those people who retired early with current conditions of those who worked longer.

Work and conditions

Our information came from the Survey of Health, Ageing and Retirement in Europe (SHARE). We looked at whether the participants were employed or not, their job (at the time of the survey and immediately before retiring), how long they had been doing their job, working hours and how stressful their job was.

In addition we looked at what the participants said about how much freedom they had at work, whether there were opportunities to develop new skills, whether their job was physically demanding or time-pressured and how supported and recognised they felt at work.

As far as survey participants’ health was concerned, we were able to see how they rated their own health, whether they were depressed, their quality of life, and how mentally and physically capable they were.

Workers better-off and better-educated

Of everyone we looked at in the study, 755 (4.3 per cent) were still working between the ages of 65 and 80. They tended, on average, to be better off and better-educated than those who had retired.

Those still working were three times as likely to be self-employed as our retired group, who were also less likely to have been in a managerial or professional job before retiring.

Those who had retired reported higher levels of stress in their last job, particularly when it came to how valued and supported they felt. They also had poorer health across the board on all the measures we looked at.

Figure 1. Prevalence of poor health by labour market situation among older men and women (aged 65 to 80 years) in percentage (n=17625

ICLS-health

These findings were still seen even after accounting for a host of other factors including their sex, education, whether or not they were in a relationship, if they had children and how well off they were, and also country affiliation.

There is robust evidence here that across Europe people who are likely to work longer are those who are self-employed or in a good job where they are in control and feel well supported and valued. They are also in better physical and mental shape than their retired counterparts.

Raising the State Pension Age or offering tax incentives to people to work longer may well favour certain groups who are already doing better than their peers in a number of ways. It could also place increased pressure on people already in poor health and in poor quality jobs.

All this needs to be taken into account by Governments looking to plug the pensions gap and by employers who will need to provide good jobs in a better, less stressful working environment if their workers are to remain productive post 65.

Further information

Photo credit: Fish, nico_enders

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

 

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