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A study in Germany has looked at the rising prevalence of poor health with age, and the potential correlation with occupation. The results show poor health is three times more frequent among older workers compared to their younger colleagues. Manual workers are most likely to say they are in poor health, compared with only 9% of dentists and judges. Evidence shows age is less relevant to the health of male managers and women in skilled commercial and administrative occupations.
In light of demographic change and the increase of the retirement age from 65 to 67, older workers are becoming increasingly important for the German labour market. While some fear increasing poverty among those who might not be able to work until the age of 67, others argue that an even higher retirement age is needed to avoid the collapse of the social security system due to lack of funding.
What is indisputable, however, is that age and health are linked. Workers’ health will become a crucial factor in the integration of older people into the labour market. Studies have also shown that work performance and motivation are negatively affected by poor health (Grund and Sliwka, 2007).
Employers have already invested a large amount of money in occupational health and safety measures. However, health is shaped not only by conditions in the workplace but also by workers’ individual lifestyles. These are beyond the influence of employers. Nonetheless, the question of whether the measures already taken are sufficient remains a subject of dispute between the trade unions and employers. Also in dispute are the types of working conditions which can have a detrimental effect on health.
A study, Self-reported general health by occupation and age in the labour force (in German), contributes to the debate by providing empirical evidence for two research questions.
Firstly, the authors identify occupations where a high prevalence of poor health among workers suggests arduous working conditions. Secondly, the authors shed light on how poor health increases with age and how this is affected by the worker’s occupation. In other words, they assume that some jobs are more appropriate for older workers than others.
The study is based on German health (GEDA) data (in German) from phone interviews conducted by the Robert Koch Institute between autumn 2008 and summer 2010. In total, 43,312 interviewees, or around 29% of all German adults in private households with a landline, took part in the survey. The self-reported general health study concentrated on the working population aged between 18 and 64, which leaves them with a sample of 26,303 observations.
Interviewees rated their general state of health on a scale of ‘very good’, ‘good’, ‘moderate’, ‘poor’ and ‘very poor’. For the analysis, these are reduced to just two categories combining ‘very good’ with ‘good’ for the first, and ‘moderate’, ‘poor’ and ‘very poor’ for the second. This scale of self-reported health is common in the literature and highly correlated with future illness.
The four age groups defined are workers aged 18 to 34 (Group 1), 35 to 44 (Group 2), 45 to 54 (Group 3) and 55 to 64 (Group 4). The sample is split into male and female subsamples to capture potential gender differences based, for instance, on women and men choosing different kinds of occupations.
The results, as shown in the table, indicate that younger workers are in general healthier. The frequency of male workers with poor health triples from 9% among the youngest group (aged between 18 and 34) to 31% among men aged between 55 and 64. This difference is only slightly smaller for female workers, with poor health rising with age from 13% to 33%.
In terms of occupation, the highest prevalence of poor health is found among unskilled manual workers (24% for men, and 35% for women) and unskilled service workers (23% for men, and 29% for women). While the former group includes welders and road builders, the latter consists, for instance, of cleaners, kitchen workers and waiters. All these occupations have a high proportion of physical work in common, which could be one explanation for the high frequency of health problems. In contrast, the lowest prevalence of poor health, less than 10%, is found among professionals such as dentists, judges and engineers.
In addition, the authors test how age and occupation interrelate. If the increase in poor health with age is compared between occupations, unskilled manual workers again stand out. There is a difference between Groups 1 and 4 of 33 percentage points for male workers (from 13% to 46%) and 50 percentage points for female workers (from 17% to 67%). In comparison, the impact of age on health seems to be significantly weaker for male managers (8 percentage points) and women in skilled commercial and administrative occupations (12 percentage points).
| Age | 18–34 | 35–44 | 45–54 | 55–64 | Total | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Men/Women | M | W | M | W | M | W | M | W | M | W |
| Engineers | 4 | 2 | 7 | 6 | 12 | 12 | 20 | 6 | 10 | 6 |
| Managers | 10 | 9 | 6 | 13 | 18 | 12 | 18 | 31 | 13 | 14 |
| Professionals | 3 | 6 | 7 | 8 | 11 | 10 | 13 | 19 | 8 | 9 |
| Skilled commercial and administrative occupations | 10 | 14 | 11 | 15 | 18 | 18 | 24 | 26 | 14 | 17 |
| Unskilled service workers | 12 | 20 | 18 | 21 | 33 | 35 | 37 | 46 | 23 | 29 |
| Unskilled manual workers | 13 | 17 | 20 | 24 | 30 | 41 | 46 | 67 | 24 | 35 |
| Total | 9 | 13 | 14 | 16 | 22 | 23 | 31 | 33 | 17 | 19 |
Note: The table reports the prevalence of poor health as a percentage of interviewees who reported poor health in selected occupations.
Source: Data from the GEDA 2009/2010 (Burr et al, 2013).
The research questions addressed here are highly relevant for the ageing German working population in general. They are particularly relevant for the political discussion about the retirement age and the adequate implementation of occupational health and safety measures. The strength of the study is that, in addition to identifying occupations with a higher prevalence of poor health, it sheds light on the interrelation of age and occupation.
However, as the authors acknowledge, due to the limitations of the data set, the findings do not show causal effects. Rather than occupations having a detrimental effect on health, some occupations might be more attractive for workers with either particularly poor or particularly good health. Another limitation of the study is that it lacks further information on the workers, such as, for instance, their qualification level or marital status. This latter point is important since health is affected not only by work but also by a wide range of other personal characteristics. These characteristics might influence both the choice of occupation and the person’s state of health.
Burr, H., Kersten, N., Kroll L., Hasselhorn, H. M. (2013), ‘Self-reported general health by occupation and age in the labour force’ (in German), Federal Health Journal – Health Research, Vol. 56, No. 3, pp. 349–358.
Grund, C. and Sliwka, D. (2007), Reference Dependent Preferences and the Impact of Wage Increases on Job Satisfaction: Theory and Evidence, Journal of Institutional and Theoretical Economics, Vol. 163, No. 2, pp. 313–335.
Andrea Hammermann, IW Köln