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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, SA; Stafford, M; Head, J; (2018) 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). Journal of Epidemiology and Community Health 10.1136/jech-2017-210328. (In press). Green open access

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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.

Type: Article
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).
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/jech-2017-210328
Publisher version: http://doi.org/10.1136/jech-2017-210328
Language: English
Additional information: 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.
Keywords: chronic disease, gerontology, longitudinal studies, workplace
URI: http://discovery.ucl.ac.uk/id/eprint/10051778
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