Educational Inequalities in Exit from Paid Employment among Dutch Workers: The Influence of Health, Lifestyle and Work
Educational Inequalities in Exit from Paid Employment among Dutch Workers: The Influence of Health, Lifestyle and Work
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DOI：
10.1371/journal.pone.0134867
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发表时间：
2015-08-07
期刊：
影响因子：
3.7
通讯作者：
Schuring, Merel
中科院分区：
文献类型：
--
作者：
Robroek, Suzan J. W.;Rongen, Anne;Schuring, Merel
社会经济地位较低的个人面临非自愿退出有偿就业的风险增加。为了为劳动力中的初级预防提供合理建议，需要深入了解社会经济地位和劳动力参与之间的中介因素的作用。因此，本研究旨在探讨健康状况、生活方式相关因素和工作特征对有偿就业退出教育差异的影响。方法14708名荷兰员工参加了1999-2008年为期10年的随访研究。基线时，教育程度、自我认知健康、生活方式（吸烟、饮酒、运动、身体质量指数）、心理社会（需求、控制、奖励）和体力工作特征通过问卷调查进行测量。每月根据税务记录确定就业状况。通过竞争风险回归分析，调查了教育、健康、生活方式、工作特征与通过残疾福利、失业、提前退休和经济不活动退出有薪就业之间的关系。采用分步法检验了这些因素对受教育程度差异在有偿就业退出中的中介作用。结果受教育程度较低的工人更有可能通过残疾福利（SHR: 1.84）、失业（SHR: 1.74）和经济不活动（SHR: 1.53）退出有薪就业，而不是由于提前退休（SHR: 0.92）。健康状况不佳或中等、不健康的生活方式和不利的工作特征与残疾津贴和失业有关，而不健康的生活方式与缺乏经济活动有关。残疾福利的教育差异有40%用健康来解释，31%用生活方式来解释，12%用工作特点来解释。对于经济不活跃和失业，高达14%和21%的教育差异可以解释，特别是与生活方式相关的因素。结论受教育程度在有偿就业退出中存在差异，这部分受健康、生活方式和工作特征的影响，尤其是对残疾福利的影响。促进健康和改善工作条件似乎是维持生产力的重要措施，特别是在受教育程度低的工人中。
BackgroundIndividuals with lower socioeconomic status are at increased risk of involuntary exit from paid employment. To give sound advice for primary prevention in the workforce, insight is needed into the role of mediating factors between socioeconomic status and labour force participation. Therefore, it is aimed to investigate the influence of health status, lifestyle-related factors and work characteristics on educational differences in exit from paid employment.Methods14,708 Dutch employees participated in a ten-year follow-up study during 1999-2008. At baseline, education, self-perceived health, lifestyle (smoking, alcohol, sports, BMI) and psychosocial (demands, control, rewards) and physical work characteristics were measured by questionnaire. Employment status was ascertained monthly based on tax records. The relation between education, health, lifestyle, work-characteristics and exit from paid employment through disability benefits, unemployment, early retirement and economic inactivity was investigated by competing risks regression analyses. The mediating effects of these factors on educational differences in exit from paid employment were tested using a step-wise approach.ResultsLower educated workers were more likely to exit paid employment through disability benefits (SHR: 1.84), unemployment (SHR: 1.74), and economic inactivity (SHR: 1.53) but not due to early retirement (SHR: 0.92). Poor or moderate health, an unhealthy lifestyle, and unfavourable work characteristics were associated with disability benefits and unemployment, and an unhealthy lifestyle with economic inactivity. Educational differences in disability benefits were explained for 40% by health, 31% by lifestyle, and 12% by work characteristics. For economic inactivity and unemployment, up to 14% and 21% of the educational differences could be explained, particularly by lifestyle-related factors.ConclusionsThere are educational differences in exit from paid employment, which are partly mediated by health, lifestyle and work characteristics, particularly for disability benefits. Health promotion and improving working conditions seem important measures to maintain a productive workforce, particularly among workers with a low education.