M ental D isorders CMD in the UK Gayan Perera Kings College London IoPPN WHERL is an interdisciplinary consortium funded by the crossresearch council Lifelong Health and Wellbeing LLHW programme under Extending Working Lives ESL0028251 ID: 755863
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Slide1
Paid employment and Common Mental Disorders (CMD) in the UK
Gayan Perera, King’s College London (IoPPN)
WHERL is an interdisciplinary consortium funded by the cross-research council Lifelong Health and Wellbeing (LLHW) programme under Extending Working Lives (ES/L002825/1)Slide2
Objective of WHerL
How has the relationship between working until and beyond State Pension Age (SPA) and health and
psychological
health changed overtime
. Slide3
ObjectiveTo investigate the association between employment status and
Common Mental Disorder (CMD) in
50-64
year old residents in England and its
stability
over time, taking advantage of
three national mental health surveys
carried out over a 14 year period.Slide4
Number of people of normal pension age and above who remain in work almost doubled
to a total of 1.4 million between the years 1993 and 2011 in England. (ONS, 2012)
P
ercentage
of older People remaining in the workforce has also increased within this time period, from
7.6%
in 1993 to
12.0% in 2011. (ONS, 2012)
Employment and Increase in older populationSlide5
Effect of paid work on health and well-being in later life
Some studies suggest paid employment among older people is beneficial for health and well-being (Adam et al., 2007;
Rohwedder
and Willis, 2010;
Behnke
, 2012;
Bonsang
et al., 2012; Calvo et al., 2013)
Some suggest that it is
detrimental
(Coe and
Zamarro
, 2011) and some that there is
no significant or meaningful relationship
(Coe and
Lindeboom
, 2008; Coe and
Zamarro
, 2011;
Behnke
, 2012;
Calvo
et al., 2013).Slide6
Method
Data: British National Surveys of Psychiatric Morbidity of 1993, 2000 and 2007
Exposure:
Paid
employment
status
Outcome:
CMD the
primary outcome – both ascertained identically in all three surveys (CMD from the revised Clinical Interview Schedule
)
Statistics:
Multivariable
logistic
regressionSlide7
Description of the sample by employment status and year of survey
1993 (n=2,385)
2000 (n=1,871)
2007 (n=1,771)
Variable
In paid Employment
Not in paid Employment
In paid Employment
Not in paid Employment
In paid Employment
Not in paid Employment
Number
1279
1169
1123
751
1111
668
CMD present
126 (9.9)
195 (
16.7
)
130 (11.6)
189 (
25.2
)
134 (12.1)
155 (
23.2
)
Reason for non-employment
Health-related non-employment
265 (22.7)
232 (
30.9
)
170 (25.4)
Other reason
904 (77.3)
519 (69.1)
498 (74.6)
Marital status
Divorced/separated
158 (12.4)
156 (13.4)
223 (19.9)
167 (22.2)
169 (15.2)
124 (18.6)
Married/cohabiting
929 (
73.0
)
766 (
65.9
)
756 (
67.3
)
434 (
57.8
)
795 (
71.6
)
414 (
62.0
)
Single
83 (6.5)
101 (8.7)
85 (7.6)
55 (7.3)
79 (7.1)
61 (9.1)
Widowed
102 (8.0)
140 (12.0)
59 (5.3)
95 (12.6)
68 (6.1)
69 (10.3)Slide8
Description of the sample by employment status and year of survey
1993 (n=2,385)
2000 (n=1,871)
2007 (n=1,771)
Variable
In paid Employment
Not in paid Employment
In paid Employment
Not in paid Employment
In paid Employment
Not in paid Employment
Highest qualification
A-level or above
280 (
21.9
)
124 (10.6)
331 (
29.5
)
133 (17.7)
477 (
43.1
)
161 (24.3)
GCSE/GCE/O-level/other
521 (40.7)
437 (37.4)
362 (32.2)
227 (30.2)
347 (31.3)
195 (29.4)
No qualifications
478 (37.4)
608 (
52.0
)
430 (38.3)
391 (
52.1
)
283 (25.6)
307 (46.3)
Social class by occupation
Professional/managerial/clerical
658 (
51.4
)
539 (46.1)
695 (
61.9
)
396 (52.7)
709 (
63.8
)
375 (56.1)
Skilled/partly skilled
558 (43.6)
541 (46.3)
381 (33.9)
293 (39.0)
344 (31.0)
242 (36.2)
Unskilled
63 (4.9)
89 (7.6)
47 (4.2)
62 (8.3)
58 (5.2)
51 (7.6)Slide9
Description of the sample by employment status and year of survey
1993 (n=2,385)
2000 (n=1,871)
2007 (n=1,771)
Variable
paid
Employment
Non-paid
Employment
paid
Employment
Non-paid
Employment
paid
Employment
Non-paid
Employment
Housing
tenure
Owned with a mortgage
616 (48.2)
279 (23.9)
552 (49.2)
161 (21.5)
471 (42.6)
123 (18.4)
Owned outright
417 (32.6)
518 (44.3)
434 (38.6)
369 (49.3)
484 (43.8)
335 (50.2)
Private or other renter
82 (6.4)
49 (4.2)
44 (3.9)
31 (4.1)
67 (6.1)
35 (5.2)
Social housing
164 (12.8)
323 (27.6)
93 (8.3)
187 (25.0)
83 (7.5)
174 (26.1)
Serious debt in the last year
51 (4.0)
48 (4.1)
49 (4.4)
72 (
9.6
)
37 (3.3)
53
(7.9
)
Seen a
family
doctor
823 (64.3)
883 (
75.5
)
741 (66.0)
559 (
74.4
)
717 (64.5)
498 (
74.6
)
Smoking status
No smoker
315 (24.6)
362 (31.0)
246 (21.9)
219 (29.2)
217 (19.5)
167 (25.0)
Ex-smoker
639 (50.0)
521 (44.6)
633 (56.4)
359 (47.8)
553 (49.8)
306 (45.8)
Current smoker
325 (25.4)
286 (24.5)
244 (21.7)
173 (23.0)
341 (30.7)
195 (29.2)
At-least one ADL impaired
191 (14.9)
427 (
36.5
)
157 (14.0)
330 (
43.9
)
327 (29.4)
351 (
52.5
)Slide10
1993 (n=2,385)
2000 (n=1,871)
2007 (n=1,771)
Adjustments
Reason for non-employment
OR
P value
OR
P value
OR
P value
Model 1: Age, gender and marital status
In paid employment
Ref
Ref
Ref
Health
6.27 (4.46- 8.83)<0.0018.72 (6.25- 12.2)<0.0017.28 (5.01- 10.6)<0.001Other 1.30 (0.96- 1.77)0.091.25 (0.89- 1.77)0.21.48 (1.05- 2.08)0.02Model 2: Model 1+ education, social class, housing tenure and serious debtIn paid employmentRefRefRefHealth5.83 (4.06- 8.38)<0.0017.01 (4.88- 10.1)<0.0015.30 (3.49- 8.04)<0.001Other 1.30 (0.96- 1.78)0.091.24 (0.86- 1.77)0.251.29 (0.91- 1.82)0.16Model 3: Model 2+ smoking status, physical health consultation and ADL impairmentIn paid employmentRefRefRefHealth3.05 (2.05- 4.55)<0.0013.56 (2.36- 5.36)<0.0012.80 (1.81- 4.36)<0.001Other 1.16 (0.85- 1.60)0.351.13 (0.79- 1.64)0.491.09 (0.76- 1.58)0.64
Odds ratios of ‘reason for non-employment’ association with CMD adjusted for various factors for 3 surveysSlide11
The prevalence of CMD was higher in people not in paid employment for health reasons but was not associated with non-employment for other reasons.
Associations had been relatively stable
in strength from 1993 to 2007.
Summary of findingsSlide12
Policy implications
Government and employers should provide support for those are willing to work longer.
Even during economic prosperous times (year 2000), association between non-employment and CMD is high.Slide13
www.wherl.ac.uk
Thank you
Paper submitted to Psychological Medicine.
Authors:
Gayan
Perera
1
, Giorgio Di Gessa
2
, Laurie M. Corna
2
, Karen Glaser
2
, Robert
Stewart
1
1
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
2
Institute of Gerontology, Department of Social Science, Health & Medicine, King’s College London, London, United Kingdom