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ESF FORWARD LOOKS Lausanne October 24th, 2008 Workshop „Well being of the Elderly“ Social productivity and well being Johannes Siegrist*, Morten Wahrendorf* * Department of Medical Sociology, University of Duesseldorf, Germany Overview (1) Background / Policy questions (2) Major progress in understandings: Scientific approach linking social productivity and well being (3) Findings from the SHARE study Work and employment and well being Informal work (voluntary work) and well being (4) Future directions of research (5) Policy implications 2 Background Job situation (if no ADL limitations) age group 55-65 austria italy belgium france greece germany denmark spain netherlands sweden switzerland 0 20 40 60 80 100 % Retired employed or self-employed Unemployed Permanently sick or disabled Source: SHARE Release II, own calculations Background Voluntary work of retired (if no ADL limitations) age < 75 sweden netherlands denmark belgium france switzerland germany austria spain greece italy 0 20 40 60 80 100 % no engagement during the last month engaged almost once during the last month Source: SHARE Release II, own calculations 2 major policy questions (1) What needs to be done to maintain as many older people as possible in employed or self-employed working conditions? By what means is it possible to reduce the proportion of employees with early exit from the labour market? How can health and well being of middle-aged to early old-aged working men and women better be protected and improved? (2) What needs to be done to enable retired people to continue or initiate socially productive activities? How can the proportion of socially productive early old people be augmented? What are the costs and benefits of extending respective opportunities and incentives? 5 Understanding the links between socially productive activities and well being Socially productive activities… have been defined as generating goods or services that are socially or economically valued by the recipient(s), whether or based upon a formal contract. provide options of goal-oriented agency to early old age populations consist of two types of goal-oriented agency with potentially beneficial effects on health and well being : paid work and voluntary or informal work. 6 The model of effort-reward imbalance (J. Siegrist 1996) Reciprocity as a general principle of cooperative exchange. Empirical evidence that non- reciprocity (“high effort / low reward”) at work and in close social relationships negatively affects health. Reward Can it be applied to other types Effort of social exchange, e.g. social productivity in early old age? “Reciprocity of effort and rewards or lack thereof may help to explain the links between productive activities and health and well being of older people.“ 1 1Siegrist, J., von dem Knesebeck, O., and Pollack, C.E., 2004. Social Productivity and Well-being of Older People: A Sociological Exploration. Social Theory & Health, 2(1): 1-17. Control and autonomy Experiencing autonomy and control over one’s productive activity must be considered an additional health-protective psychosocial resource. Control over one’s agency reinforces feelings of self-efficacy and mastery and, thus, reduces uncertainty, threat and anxiety. 8 Summary of scientific approach The socio-emotional consequences of socially productive activities is considered particularly relevant in early old age where options of agency, control and reward resulting from core social roles are becoming less frequent and less pronounced. Being socially productive in a formal (e.g. continued paid work) or informal (e.g. volunteering) activity that provides recurrent reciprocity and autonomy is assumed to exert beneficial effects on health and well being in early old age. Conversely, experiencing recurrent non-reciprocity and lack of autonomy in such an activity reduces the probability of healthy ageing. 9 Findings from the SHARE study Social productivity and well being in early old age: the role of work and employment 10 Quality of work in Europe 15 14 Mean reward score 13 wave I wave II 12 11 10 SE DK DE NL BE FR CH AT IT ES GR PO CZ IL Country Figure: Quality of work across SHARE countries (mean scores of reward at work (range 5-20) and standard error) in wave I and wave II Quality of work and depressive symptoms 30% Prevalence of depressive symptoms in % 25% 20% yes no 15% 10% 5% northern western southern northern western southern Effort-Reward imbalance Low control Figure: Prevalence of depressive symptoms in wave II (EURO-D) according to low quality of work in wave I (yes= highest tertile effort-reward ratio or low control; no= lower tertiles) Quality of work and decreased self-rated health Prevalence of decreased self-rated health in % 30% 25% 20% yes no 15% 10% 5% northern western southern northern western southern Effort-Reward imbalance Low conctrol Figure: Prevalence of decreased self-rated health in wave II according to low quality of work in wave I (yes= highest tertile effort-reward ratio or low control; no= lower tertiles) Low quality of work and well-being Well-being indicator Variables Euro-D decreased SRH Gender OR CI 95% OR CI 95% Male - - Lower level of well- Female 1.94 (1.63 - 2.32) 1.29 (1.10 - 1.51) being is observed in Age women. <55 years - - 55-59 years .86 (0.71 - 1.04) 1.02 (0.86 - 1.22) Interestingly, adjusting >= 60 years .76 (0.58 - 0.99) 1.31 (1.05 - 1.63) Income for quality of work, the Low 1.09 (0.87 - 1.37) 1.21 (0.99 - 1.48) effect of SES on well- Medium 1.07 (0.87 - 1.31) 1.18 (0.98 - 1.41) being is reduced. High - Education ERI and, to some extent Low 1.03 (0.82 - 1.30) 1.12 (0.91 - 1.39) low control, remain as Medium 1.02 (0.82 - 1.26) 1.24 (1.02 - 1.51) High - - predictors of well-being ERI in the multivariate Yes 1.37 (1.14 - 1.64) 1.41 (1.20 - 1.66) model. No - - Low control Yes 1.29 (1.06 - 1.58) 1.05 (0.87 - 1.27) No - - Note. Adjusted for country affiliation and prior well-being 14 Quality of work and old age employment rate Source: SHARE Release II, ELSA Wave II & Eurostat, own calculations Findings from the SHARE study Social productivity and well being in early old age: the role of informal work 16 Voluntary work in Europe > 20 % 15 – 20 % 10 – 15 % < 10 % Figure: Prevalence of voluntary across SHARE and ELSA Voluntary work and quality of life 42 40 38 Mean CASP score not active 36 active / reciprocal active / non-reciprocal 34 32 30 northern western southern countries countries countries Figure: Quality of life in wave II (mean scores of CASP-12 (range 12-48) and standard errors) according to voluntary work (3 categories) in wave I Voluntary work and depressive symptoms 30% Prevalence of depressive symptoms in % 25% 20% not active active / reciprocal active / non-reciprocal 15% 10% 5% northern countries western countries southern countries Figure: Prevalence of depressive symptoms in wave II (EURO-D) according to voluntary work (3 categories) in wave I Social productivity and quality of life Table 1: Multilevel estimates for quality of life in wave 2 (CASP): Regression coefficients and standard errors Empty Model 1 Model • Most of the variance can be Fixed parameters attributed to the individual Income Low -0.74*** level. Medium -0.22 High - • Low income and low Education Low -0.67*** Medium -0.11 education lead to lower High - quality of work in wave II. Voluntary work Not active - Active / reciprocal activity 0.82*** • The effect of volunteering is Active / Non-reciprocal 0.72 restricted to the group which Quality of life(wave 1) 0.47*** experiences reciprocity in Random parameters exchange. Level 1: within country 5.952*** 4.839*** Level 2: between country 2.542*** 1.473 Note. Model 1 additionally adjusted for age, gender, partnership and ADL limitations 20 Summary (1) The results emphasize the importance of the social opportunity structure (formal and informal work) in supporting and strengthening older people’s health and well being. (2) The theoretical notions of autonomy and reward resulting from reciprocal exchange explained variations in well being to a substantial degree. Being socially productive in a rewarding and control-enhancing formal (paid work) or informal (volunteering) social role is associated with better well being. (3) This holds true for different indicators of well being (depressive symptoms, self-rated health, quality of life), and associations are consistent across different country groups in cross-sectional and longitudinal analyses. Future directions of research (1) To study the effect of differential occupational trajectories on associations of socially productive activities with health and well being. (2) To study the effect of quality of work on occupational trajectories including retirement. (3) To analyze variations of these associations according to different social policies (welfare states). Does the effect of poor quality of work (ERI) on depression (CES-D) vary according to different social policies (welfare states)? Variations according to different welfare states: first findings 3 2 Odds ratio no yes 1 0 social conservative liberal social conservative liberal democratic democratic Effort-Reward imbalance Low conctrol Figure: Associations between low quality of work (yes= highest tertile effort-reward ratio or low control; no= lower tertiles) and depressive symptoms: Odds ratios adjusted for socioeconomic position (education, income), age and gender. Policy implications I: Formal work (1) Improving monitoring activities of health-adverse working conditions (including traditional physical and chemical hazards and more recent psychosocial hazards). (2) Monitoring occupational high risk groups, in particular those employed in precarious work, temporary and irregular work, as well as those working in risky jobs. (3) Increasing the flexibility of work time arrangements including broader opportunities of part-time work and continued training as well as ‘flexicurity’ models of occupational careers. Policy implications II: Informal work (1) Further development of opportunities of informal work for third age population groups. (2) Creation of new social roles in the context of an emerging civil society (liberalization of legal restrictions, tax allowance, positive attitudes towards active ageing) (3) Enrichment of informal work by enhancing opportunities of reward (recognition and esteem) and control (autonomy and self- esteem).
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