Social Productivity and Well-being of Older People – Baseline by malj

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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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