Occupational social class trajectories in physical functioning among employed women from midlife to retirement
Occupational social class trajectories in physical functioning among employed women from midlife to retirement
复制标题
DOI：
10.1186/s12889-019-7880-0
复制
发表时间：
2019-11-14
影响因子：
4.5
通讯作者：
Lallukka, Tea
中科院分区：
文献类型：
--
作者：
Lahelma, Eero;Pietilainen, Olli;Lallukka, Tea
背景 先前对员工健康轨迹的阶级差异的分析常常忽略了女性和退休过渡。我们研究了芬兰女性员工从中年到退休年龄身体机能的社会阶层轨迹，以及退休的过渡是否改变了这些轨迹。方法 数据来源于第 1 至 3 阶段（2000 年至 2012 年）对芬兰赫尔辛基市 40 岁至 60 岁基线员工的邮件调查（n = 8960，80% 为女性，答复率为 69-83%）。我们纳入了年龄在 40-72 岁之间的第 1-3 阶段的受访者 (n = 6976)。我们区分了较高和较低的社会阶层以及就业状况，即就业、强制退休和残疾退休。简表 36 身体成分摘要用于测量身体功能。混合效应增长曲线模型用于评估社会阶层和就业状况与年龄功能之间的关系。结果 对于就业女性来说，下层阶级的身体机能恶化速度比上层阶级更快，40-65 岁的阶级轨迹扩大。强制退休后，两个阶层的功能均恶化，而残疾退休后，功能有所改善。在各种就业状况中，功能在年龄较大时趋于一致，残疾退休者的功能赶上了就业者和强制退休者的更好功能。就业状况改变了轨迹，连续就业和强制退休妇女的功能恶化，但残疾退休妇女的轨迹有所改善，达到与就业和强制退休妇女相似的水平。所有就业状况群体中仍然存在社会阶层不平等。结论 总体而言，我们的结果为累积劣势模型提供了证据，下层阶级的工作暴露积累可能导致他们的健康状况不佳。
Background Prior analyses of class differences in health trajectories among employees have often omitted women and transitions to retirement. We examined social class trajectories in physical functioning among Finnish female employees from midlife to retirement age, and whether transitions to retirement modified these trajectories. Methods Data were derived from mail surveys at Phases 1-3 (2000-2012) among employees of the City of Helsinki, Finland, aged 40-60 at baseline (n = 8960, 80% women, response rates 69-83%). We included respondents to any of the Phases 1-3 aged 40-72 (n = 6976). We distinguished higher and lower social classes, and employment statuses, i.e. employed, mandatorily retired and disability-retired. Short Form 36 physical component summary was used to measure physical functioning. Mixed-effect growth curve models were used to assess the association of social class and employment status with functioning over age. Results For employed women, physical functioning deteriorated faster in the lower than in the higher class, with class trajectories widening in ages 40-65. After mandatory retirement, functioning deteriorated in both classes, whereas after disability retirement, functioning improved. Across employment statuses, functioning converged at older ages, and the disability-retired caught up with the better functioning of the employed and mandatorily retired. Employment status modified the trajectories, as among the continuously employed and mandatorily retired women functioning deteriorated, but among the disability-retired, trajectories improved and reached a similar level with employed and mandatorily retired women. Social class inequalities remained in all employment status groups. Conclusions Overall, our results suggest evidence for the cumulative disadvantage model, with accumulating work exposures among lower classes potentially contributing to their trajectories of ill health.