@article{discovery10051778, year = {2018}, volume = {72}, number = {10}, 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).}, month = {October}, pages = {951--957}, journal = {Journal of Epidemiology and Community Health}, note = {Copyright {\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.}, issn = {1470-2738}, keywords = {chronic disease, gerontology, longitudinal studies, workplace}, author = {Fleischmann, M and Carr, E and Xue, B and Zaninotto, P and Stansfeld, SA and Stafford, M and Head, J}, url = {http://doi.org/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.} }