Do psychosocial working conditions contribute to healthy and active aging? Studies of mortality, late-life health, and leisure

The growing demographic challenge posed by an aging population makes finding predictors of health in old age increasingly important. This thesis investigated long-term associations between midlife psychosocial working conditions and late-life health and leisure and examined whether sense of coherence in midlife modified the association between psychosocial working conditions and all-cause mortality. The studies were based on individually linked data from the Swedish Cause of Death Register and two Swedish longitudinal surveys, the Level of Living Survey (LNU) and the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD).

The results of Study I and Study II suggest that self-reported adverse psychosocial working conditions in late midlife, especially low job control, high strain, or passive jobs, were associated with complex health problems and limitations in physical functioning 20-24 years later. However, women and men seemed to be vulnerable to different self-reported psychosocial working conditions. High job strain (high psychological demands and low control) was more negative for women than men. Passive jobs (low psychological demands and low control) were negative for men but not for women. The results of Study III suggest that a weak sense of coherence magnified the association between occupation-based (measured with a job exposure matrix) high job strain in midlife and mortality in women and men and self-reported passive jobs in midlife and mortality in men. The results of Study IV suggest that occupation-based active jobs (high psychological demands and high control) in midlife were associated with physical, social, and intellectual/cultural activity 23 years later in women and men.

In summary, the results underscore the importance of psychosocial working conditions in midlife for health, physical functioning, and leisure activity after retirement²and thus for healthy and active aging. It is therefore important to reduce stress at work but at the same time induce intellectual stimulation and personal growth. Moreover, it is important to find ways to strengthen sense of coherence in midlife to buffer the negative influence of adverse psychosocial working conditions on health. Investing in healthy workplaces and strengthening sense of coherence to improve the health of workers may reduce societal costs during working age. It may also lower the cost of health and social care by improving the health of the older population. Hence, it would be a double-win investment for society.

List of scientific papers

I. Nilsen, C., Andel, R., Fors, S., Meinow, B., Mattsson, A. D., & Kåreholt, I. (2014). Associations between work-related stress in late midlife, educational attainment, and serious health problems in old age: a longitudinal study with over 20 years of follow-up. BMC Public Health. 14(1), 878.
https://doi.org/10.1186/1471-2458-14-878

II. Nilsen, C., Agahi, N., & Kåreholt, I. (2017). Work stressors in late midlife and physical functioning in old age. Journal of Aging and Health. 29(5), 893-911.
https://doi.org/10.1177/0898264316654673

III. Nilsen, C., Andel, R., Fritzell, J., & Kåreholt, I. (2016). Work-related stress in midlife and all-cause mortality: can sense of coherence modify this association? The European Journal of Public Health. 26(6), 1055-1061.
https://doi.org/10.1093/eurpub/ckw086

IV. Nilsen, C., Andel, R., Fritzell, J., Agahi, N., & Kåreholt, I. The influence of active jobs in midlife on leisure activity in old age. [Submitted]