Quality of life, work ability, and self employment: a population survey of entrepreneurs, farmers, and salary earners.

OBJECTIVES: Self employment is increasing but it is not yet known how its different forms affect health, quality of life, and work ability. We compared the work ability, subjective quality of life (QoL), and health-related quality of life (HRQoL) of entrepreneurs both with and without personnel, farmers, and salaried workers. We investigated which domains of HRQoL are associated with work status.
METHODS: A nationally representative general population sample comprising 5834 Finns aged between 30 and 64. Work ability was measured using the work ability index (WAI), HRQoL using 15D and EQ-5D, and QoL with self reported global quality of life.
RESULTS: Entrepreneurs with personnel had better work ability than salary earners, but there were no differences in QoL or HRQoL between the entrepreneurs and salary earners. Farmers scored lowest on all measures; this finding remained even after adjusting for age, sex, marital status, education, and chronic conditions. The low WAI score of farmers was mainly explained by poor subjective work ability, while their low 15D score was mainly the result of poor functioning in the psychosocial domains of HRQoL. The low EQ-5D score of farmers was explained by problems with mobility, usual activities, and with pain or discomfort.
CONCLUSIONS: Farmers have poorer work ability, QoL, and HRQoL than other working groups, but this does not appear to be caused by physical health problems. From a research point of view, farmers should be categorised separately from other forms of entrepreneurship. From a public health point of view, improving farmers' wellbeing may require psychosocial interventions exceeding traditional health promotion.