@phdthesis{discovery10043871,
            note = {Unpublished},
          school = {UCL (University College London)},
           pages = {1--1},
           month = {February},
       booktitle = {UCL (University College London)},
          editor = {R Watt and G Tsakos and P Demakakos},
           title = {Psychosocial work environment and oral health in the English Longitudinal Study of Ageing},
            year = {2018},
             url = {https://discovery.ucl.ac.uk/id/eprint/10043871/},
          author = {Aldalooj, Esraa},
        abstract = {BACKGROUND: A growing body of literature shows that psychosocial work environment
influences the health of employees and their quality of life. A few studies also suggest
that psychosocial work environment might influence oral health. However, the evidence
for an association between work stress and oral health is very limited and inconclusive
in terms of temporality, as the current literature was exclusively based on crosssectional
designs. Given the increasing proportion of older adults in the population and
workforce, there is a need to investigate the potential role of psychosocial work factors
as a broader determinant of oral health.
AIM: The aim of this thesis was to examine whether psychosocial work environment
was a determinant of oral health among older working adults, and whether this
association was explained by demographic, socio-economic and behavioural factors.
METHODS: Secondary analysis of data from the English Longitudinal Study of Ageing
(ELSA) waves 3 (2006-07), 4 (2008-09) and 5 (2010-11) was conducted. The sample
comprised a total of 1,854 adults aged 50 to 65 years in the cross-sectional analysis, and
1,542 and 1,058, respectively, in two different sets of longitudinal analyses. Two key
measures of psychosocial work environment were derived from the ELSA self-report
questionnaire, reflecting on the work demand-control model (work control) and the
effort-reward imbalance model (work quality). Oral health outcomes were assessed
using self-rated oral health, oral health-related quality of life (OHRQoL) and selfreported
edentulousness. Logistic regression models were used to estimate the odds
ratio of poor oral health outcomes for different psychosocial work environment
exposures, sequentially adjusted for age, gender, marital status, education, income, type
of work and smoking status.
RESULTS: When compared to those with high levels of work control, those at low levels
had higher odds of poor self-rated oral health (OR 1.44; 95\% CI: 1.08-1.93) and poor
OHRQoL (OR 1.91; 95\% CI: 1.10-3.31) in the cross-sectional analysis. Similarly, low
work quality was associated with poor self-rated oral health (OR 1.48; 95\% CI: 1.08-
2.03) and OHRQoL (OR 1.91; 95\% CI: 1.15-3.15). In the longitudinal analysis, low
quality of work at wave 3 also predicted poor self-rated oral health (OR 1.43; 95\% CI:
1.01-2.04) and OHRQoL (OR 1.65; 95\% CI: 1.06-2.57) four years later when compared
to high quality of work, though the association between quality of work and OHRQoL
was weaker in the longitudinal analysis compared to the cross-sectional. Some evidence
was found between repeated exposure to low quality of work at waves 3 and 4 with
worse OHRQoL at wave 5 with OR 2.38 (95\% CI: 1.09-5.20). All associations were
independent from selected covariates at wave 3.
CONCLUSION: The role of psychosocial work environment on poor oral health appears to
be limited among older English working adults. The study found some evidence of
associations between work quality and OHRQoL in the cross-sectional, longitudinal and
repeated exposure analyses. There was some weak evidence for the association between
work control and oral health status. This thesis contributes to the understanding of the
links between psychosocial work conditions and oral health in later life.}
}