Changes in autonomy, job demands and working hours after diagnosis of chronic disease: a comparison of employed and self-employed older persons using the English Longitudinal Study of Ageing (ELSA)

Changes in autonomy, job demands and working hours after diagnosis of chronic disease: a comparison of employed and self-employed older persons using the English Longitudinal Study of Ageing (ELSA). Fleischmann, M., Carr, E., Xue, B., Zaninotto, P., Stansfeld, S. A., Stafford, M., & Head, J. J Epidemiol Community Health, 72:951–957, 2018.

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Background Modifications in working conditions can accommodate changing needs of chronically ill persons. The self-employed may have more possibilities than employees to modify their working conditions. We investigate how working conditions change following diagnosis of chronic disease for employed and self-employed older persons. Methods We used waves 2–7 from the English Longitudinal Study of Ageing (ELSA). We included 1389 participants aged 50–60 years who reported no chronic disease at baseline. Using fixed-effects linear regression analysis, we investigated how autonomy, physical and psychosocial job demands and working hours changed following diagnosis of chronic disease. Results For employees, on diagnosis of chronic disease autonomy marginally decreased (−0.10, 95% CI −0.20 to 0.00) and physical job demands significantly increased (0.13, 95% CI 0.01 to 0.25), whereas for the self-employed autonomy did not significantly change and physical job demands decreased on diagnosis of chronic disease (−0.36, 95% CI −0.64 to –0.07), compared with prediagnosis levels. Psychosocial job demands did not change on diagnosis of chronic disease for employees or the self-employed. Working hours did not change for employees, but dropped for self-employed (although non-significantly) by about 2.8 hours on diagnosis of chronic disease (−2.78, 95% CI −6.03 to 0.48). Conclusion Improvements in working conditions after diagnosis of chronic disease were restricted to the self-employed. This could suggest that workplace adjustments are necessary after diagnosis of chronic disease, but that the self-employed are more likely to realise these. Policy seeking to extend working life should consider work(place) adjustments for chronically ill workers as a means to prevent early exit from work.

@article{fleischmann_changes_2018,
	title = {Changes in autonomy, job demands and working hours after diagnosis of chronic disease: a comparison of employed and self-employed older persons using the {English} {Longitudinal} {Study} of {Ageing} ({ELSA})},
	volume = {72},
	copyright = {© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/},
	issn = {0143-005X, 1470-2738},
	shorttitle = {Changes in autonomy, job demands and working hours after diagnosis of chronic disease},
	url = {https://jech.bmj.com/content/early/2018/06/23/jech-2017-210328},
	doi = {10.1136/jech-2017-210328},
	abstract = {Background Modifications in working conditions can accommodate changing needs of chronically ill persons. The self-employed may have more possibilities than employees to modify their working conditions. We investigate how working conditions change following diagnosis of chronic disease for employed and self-employed older persons.
Methods We used waves 2–7 from the English Longitudinal Study of Ageing (ELSA). We included 1389 participants aged 50–60 years who reported no chronic disease at baseline. Using fixed-effects linear regression analysis, we investigated how autonomy, physical and psychosocial job demands and working hours changed following diagnosis of chronic disease.
Results For employees, on diagnosis of chronic disease autonomy marginally decreased (−0.10, 95\% CI −0.20 to 0.00) and physical job demands significantly increased (0.13, 95\% CI 0.01 to 0.25), whereas for the self-employed autonomy did not significantly change and physical job demands decreased on diagnosis of chronic disease (−0.36, 95\% CI −0.64 to –0.07), compared with prediagnosis levels. Psychosocial job demands did not change on diagnosis of chronic disease for employees or the self-employed. Working hours did not change for employees, but dropped for self-employed (although non-significantly) by about 2.8 hours on diagnosis of chronic disease (−2.78, 95\% CI −6.03 to 0.48).
Conclusion Improvements in working conditions after diagnosis of chronic disease were restricted to the self-employed. This could suggest that workplace adjustments are necessary after diagnosis of chronic disease, but that the self-employed are more likely to realise these. Policy seeking to extend working life should consider work(place) adjustments for chronically ill workers as a means to prevent early exit from work.},
	language = {en},
	urldate = {2018-07-01},
	journal = {J Epidemiol Community Health},
	author = {Fleischmann, Maria and Carr, Ewan and Xue, Baowen and Zaninotto, Paola and Stansfeld, Stephen A. and Stafford, Mai and Head, Jenny},
	year = {2018},
	pmid = {29936420},
	keywords = {chronic disease, gerontology, longitudinal studies, workplace},
	pages = {951--957},
}

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This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/","issn":"0143-005X, 1470-2738","shorttitle":"Changes in autonomy, job demands and working hours after diagnosis of chronic disease","url":"https://jech.bmj.com/content/early/2018/06/23/jech-2017-210328","doi":"10.1136/jech-2017-210328","abstract":"Background Modifications in working conditions can accommodate changing needs of chronically ill persons. The self-employed may have more possibilities than employees to modify their working conditions. We investigate how working conditions change following diagnosis of chronic disease for employed and self-employed older persons. Methods We used waves 2–7 from the English Longitudinal Study of Ageing (ELSA). We included 1389 participants aged 50–60 years who reported no chronic disease at baseline. Using fixed-effects linear regression analysis, we investigated how autonomy, physical and psychosocial job demands and working hours changed following diagnosis of chronic disease. Results For employees, on diagnosis of chronic disease autonomy marginally decreased (−0.10, 95% CI −0.20 to 0.00) and physical job demands significantly increased (0.13, 95% CI 0.01 to 0.25), whereas for the self-employed autonomy did not significantly change and physical job demands decreased on diagnosis of chronic disease (−0.36, 95% CI −0.64 to –0.07), compared with prediagnosis levels. Psychosocial job demands did not change on diagnosis of chronic disease for employees or the self-employed. Working hours did not change for employees, but dropped for self-employed (although non-significantly) by about 2.8 hours on diagnosis of chronic disease (−2.78, 95% CI −6.03 to 0.48). Conclusion Improvements in working conditions after diagnosis of chronic disease were restricted to the self-employed. This could suggest that workplace adjustments are necessary after diagnosis of chronic disease, but that the self-employed are more likely to realise these. Policy seeking to extend working life should consider work(place) adjustments for chronically ill workers as a means to prevent early exit from work.","language":"en","urldate":"2018-07-01","journal":"J Epidemiol Community Health","author":[{"propositions":[],"lastnames":["Fleischmann"],"firstnames":["Maria"],"suffixes":[]},{"propositions":[],"lastnames":["Carr"],"firstnames":["Ewan"],"suffixes":[]},{"propositions":[],"lastnames":["Xue"],"firstnames":["Baowen"],"suffixes":[]},{"propositions":[],"lastnames":["Zaninotto"],"firstnames":["Paola"],"suffixes":[]},{"propositions":[],"lastnames":["Stansfeld"],"firstnames":["Stephen","A."],"suffixes":[]},{"propositions":[],"lastnames":["Stafford"],"firstnames":["Mai"],"suffixes":[]},{"propositions":[],"lastnames":["Head"],"firstnames":["Jenny"],"suffixes":[]}],"year":"2018","pmid":"29936420","keywords":"chronic disease, gerontology, longitudinal studies, workplace","pages":"951–957","bibtex":"@article{fleischmann_changes_2018,\n\ttitle = {Changes in autonomy, job demands and working hours after diagnosis of chronic disease: a comparison of employed and self-employed older persons using the {English} {Longitudinal} {Study} of {Ageing} ({ELSA})},\n\tvolume = {72},\n\tcopyright = {© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/},\n\tissn = {0143-005X, 1470-2738},\n\tshorttitle = {Changes in autonomy, job demands and working hours after diagnosis of chronic disease},\n\turl = {https://jech.bmj.com/content/early/2018/06/23/jech-2017-210328},\n\tdoi = {10.1136/jech-2017-210328},\n\tabstract = {Background Modifications in working conditions can accommodate changing needs of chronically ill persons. The self-employed may have more possibilities than employees to modify their working conditions. We investigate how working conditions change following diagnosis of chronic disease for employed and self-employed older persons.\nMethods We used waves 2–7 from the English Longitudinal Study of Ageing (ELSA). We included 1389 participants aged 50–60 years who reported no chronic disease at baseline. Using fixed-effects linear regression analysis, we investigated how autonomy, physical and psychosocial job demands and working hours changed following diagnosis of chronic disease.\nResults For employees, on diagnosis of chronic disease autonomy marginally decreased (−0.10, 95\\% CI −0.20 to 0.00) and physical job demands significantly increased (0.13, 95\\% CI 0.01 to 0.25), whereas for the self-employed autonomy did not significantly change and physical job demands decreased on diagnosis of chronic disease (−0.36, 95\\% CI −0.64 to –0.07), compared with prediagnosis levels. Psychosocial job demands did not change on diagnosis of chronic disease for employees or the self-employed. Working hours did not change for employees, but dropped for self-employed (although non-significantly) by about 2.8 hours on diagnosis of chronic disease (−2.78, 95\\% CI −6.03 to 0.48).\nConclusion Improvements in working conditions after diagnosis of chronic disease were restricted to the self-employed. This could suggest that workplace adjustments are necessary after diagnosis of chronic disease, but that the self-employed are more likely to realise these. Policy seeking to extend working life should consider work(place) adjustments for chronically ill workers as a means to prevent early exit from work.},\n\tlanguage = {en},\n\turldate = {2018-07-01},\n\tjournal = {J Epidemiol Community Health},\n\tauthor = {Fleischmann, Maria and Carr, Ewan and Xue, Baowen and Zaninotto, Paola and Stansfeld, Stephen A. and Stafford, Mai and Head, Jenny},\n\tyear = {2018},\n\tpmid = {29936420},\n\tkeywords = {chronic disease, gerontology, longitudinal studies, workplace},\n\tpages = {951--957},\n}\n\n","author_short":["Fleischmann, M.","Carr, E.","Xue, B.","Zaninotto, P.","Stansfeld, S. 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