Daniel Holman.
Abstract
OBJECTIVES: Increasing life expectancy has led governments to implement reforms aimed at delaying retirement. Chronic conditions are an important barrier to this given their association with pain, functional limitations, depression and ultimately lower life expectancy. Chronic diseases are gendered in terms of these characteristics, as well as their population prevalence. I examined the extent to which gender moderates the extent to which different chronic conditions lead to disability employment exit, the proportion of exits they account for and key mediators in this process.
METHODS: Data from waves 1 to 8 of the English Longitudinal Study of Ageing were analysed. I followed employees aged 50-70 years until they experienced disability employment exit, or were censored. I analysed the influence of chronic conditions, functional limitations, pain, depressive symptoms and subjective life expectancy using discrete time survival analysis. All analyses were carried out separately by gender if a significant interaction was found. The mediation analysis was carried out using the Karlson/Holm/Breen method.
RESULTS: No significant gender interactions were found for the risk of chronic conditions on disability employment exit. Lung disease (OR 4.1; 95% CI 2.8 to 5.9), cancer (OR 2.9; 95% CI 2.1 to 4.0) and arthritis (OR 2.6; 95% CI 2.1 to 3.3) were the strongest determinants. Depressive symptoms (OR 3.2; 95% CI 2.5 to 4.1) were also a strong determinant, and along with arthritis, explained a greater proportion of women than men's exits given differences in prevalence. Pain and various types of functional limitations were important mediators of exit as well as determinants in their own right.
CONCLUSION: The results suggest that gender differences in the prevalence of different chronic conditions result in differences in the proportion of disability employment exits they account for in the population. Targeted and tailored interventions, for example, in the workplace might take this into account. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
OBJECTIVES: Increasing life expectancy has led governments to implement reforms aimed at delaying retirement. Chronic conditions are an important barrier to this given their association with pain, functional limitations, depression and ultimately lower life expectancy. Chronic diseases are gendered in terms of these characteristics, as well as their population prevalence. I examined the extent to which gender moderates the extent to which different chronic conditions lead to disability employment exit, the proportion of exits they account for and key mediators in this process.
METHODS: Data from waves 1 to 8 of the English Longitudinal Study of Ageing were analysed. I followed employees aged 50-70 years until they experienced disability employment exit, or were censored. I analysed the influence of chronic conditions, functional limitations, pain, depressive symptoms and subjective life expectancy using discrete time survival analysis. All analyses were carried out separately by gender if a significant interaction was found. The mediation analysis was carried out using the Karlson/Holm/Breen method.
RESULTS: No significant gender interactions were found for the risk of chronic conditions on disability employment exit. Lung disease (OR 4.1; 95% CI 2.8 to 5.9), cancer (OR 2.9; 95% CI 2.1 to 4.0) and arthritis (OR 2.6; 95% CI 2.1 to 3.3) were the strongest determinants. Depressive symptoms (OR 3.2; 95% CI 2.5 to 4.1) were also a strong determinant, and along with arthritis, explained a greater proportion of women than men's exits given differences in prevalence. Pain and various types of functional limitations were important mediators of exit as well as determinants in their own right.
CONCLUSION: The results suggest that gender differences in the prevalence of different chronic conditions result in differences in the proportion of disability employment exits they account for in the population. Targeted and tailored interventions, for example, in the workplace might take this into account. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Entities:
Keywords:
chronic conditions; disability; employment exit; functional limitations; gender
Mesh：
Year: 2019
PMID： 30988005 DOI： 10.1136/oemed-2018-105493
Source DB: PubMed Journal: Occup Environ Med ISSN： 1351-0711 Impact factor: 4.402