Occupation, health behaviour and mortality
Promotion of Work Ability and Health Finnish Institute of Occupational Health Helsinki, Finland
von Bonsdorff, Monika
Promotion of Work Ability and health Finnish Institute of Occupational Health Helsinki, Finland
There is strong evidence that even though educational level is associated to mortality and morbidity, a large proportion of differences in mortality are explained by health behaviour and other lifestyle factors. The associations are complex, and more studies are needed to clarify the role of each factor.
The purpose of this study was to examine longitudinally the associations between occupation, work characteristics, functional capacity and health behaviour of middle-aged employees and all cause mortality.
The study material is comprised of a longitudinal questionnaire study of Finnish municipal workers which was conducted at the Finnish Institute of Occupational Health in 1981-1997. At the baseline, all participants (n=6257) were occupationally active. In 2009, the vital status and dates of death were added to the data. By then, 2020 respondents had died.
The dependent variable was the time from 1981 to the year of death or to the end of the follow-up. The measure of functional capacity covered issues of managing daily activities. Health behaviour (i.e. alcohol consumption, use of tobacco, physical exercise), characteristics of work (responsibility for others, physical workload), marital status, occupational group, and the age, at which a person began his/her work career were also used in the analysis.
Kaplan-Mayer method was used to estimate the survivorship functions for the levels of occupational group. The hazard ratios of all cause mortality were estimated using Cox proportional hazard model with time varying covariates.
The results showed that there were strong differences in mortality between occupational groups. When other factors were added into the models, the role of occupation diminished and the strongest predictors of mortality proved to be functional capacity and smoking. Also work characteristics (among men) and marital status (among women) were important.
It seems evident that occupation alone does not explain mortality. Health behaviour and functional capacity are more important. The significant role of mental characteristics of the work suggests that also working life qualities may have long-term effects on mortality.