Jorma Järvisalo and Seppo Koskinen, editors Jorma Järvisalo and Seppo Koskinen, Ilmarinen, Juhani Raija Gould, Dimensions of Helsinki 2008 Helsinki Work Ability Results of the Health 2000 Survey Raija Gould, Juhani Ilmarinen, Jorma Järvisalo and Seppo Koskinen, editors Work ability is an essential prerequisite for well-being Ability Dimensions of Work and employment. This book describes the work ability of working-aged Finns on the basis of material from the extensive Health 2000 Survey. It focuses on the multidimensionality of work ability. How are health, work, expertise, and attitudes related to perceived work ability? Are the unemployed able to work, and does the work ability of older workers suffice for lengthening their careers? Furthermore, has the work ability of the Finnish population changed over the last few decades? By shedding light on these questions, the book provides a comprehensive information basis for everyone who is interested in the contents and promotion of work ability. Dimensions of Work Ability Results of the Health 2000 Survey Raija Gould, Juhani Ilmarinen, Jorma Järvisalo and Seppo Koskinen, editors Helsinki 2008 Publishers Finnish Centre for Pensions (ETK) FI-00065 Eläketurvakeskus, Finland www.etk.fi The Social Insurance Institution (Kela) PL 450, FI-00101 Helsinki, Finland www.kela.fi National Public Health Institute (KTL) Mannerheimintie 166, FI-00300 Helsinki, Finland www.ktl.fi Finnish Institute of Occupational Health (FIOH) Topeliuksenkatu 41aA, FI-00250 Helsinki, Finland www.ttl.fi Graphic design Katri Saarteinen Layout Merja Raunis Figures Heidi Nyman ISBN 978-951-691-096-6 (printed book) ISBN 978-951-691-097-3 (PDF) Waasa Graphics Oy, Vaasa 2008 Dimensions_of_Work_Ability.indb 2 23.4.2008 13:18:49 Preface The focus on the population’s work ability has changed over the years due to changes in working life, public health, population structure, culture and societal norms. Comprehensive and up-to-date knowledge on different dimensions of work ability is essential for the promotion of longer careers, employment growth and wellbeing of the population of working age and beyond. This book provides baseline results on work ability of the Fin- nish Health 2000 Survey. It is the most comprehensive study on the population’s work ability carried out in Finland. The book is a product of a long and broad collaboration which started in the planning group of the research project already in the last millennium. The editors and authors of the book represent various organizations and disciplines as well as different angles of the research on work ability. The book is an abbreviated version of the full Finnish-language report “Työkyvyn ulottuvuudet” published in 2006. The editors and authors shortened the original Finnish-language texts. They were then translated into English by Georgianna Oja. The translated texts were further edited by the editors, authors and other experts. We wish to thank all those involved in this process. This report as well as the original Finnish-language report are avai- lable on the website of the Finnish Centre for Pensions at www.etk.fi. We hope that the book provides to international readers valuable information on work ability and a source of inspiration for many new research projects. The editors Dimensions_of_Work_Ability.indb 3 23.4.2008 13:18:49 Contributors Raija Gould, Researcher Finnish Centre for Pensions [email protected] Juhani Ilmarinen, Theme Director Finnish Institute of Occupational Health [email protected] Aila Järvikoski, Professor University of Lapland [email protected] Jorma Järvisalo, Research Professor The Social Insurance Institution [email protected] Seppo Koskinen, Chief Physician National Public Health Institute [email protected] Tuija Martelin, Senior Researcher National Public Health Institute [email protected] Tiina Pensola, Senior Researcher Rehabilitation Foundation [email protected] Anu Polvinen, Researcher Finnish Centre for Pensions [email protected] Päivi Sainio, Researcher National Public Health Institute [email protected] Jorma Seitsamo, Specialized Researcher Finnish Institute of Occupational Health [email protected] Kaija Tuomi, Senior Researcher (emer.) Finnish Institute of Occupational Health [email protected] Dimensions_of_Work_Ability.indb 4 23.4.2008 13:18:49 Abstract Research on work ability is important from the perspective of the individual, work organisation and society. Good work ability increases wellbeing and supports employment. Knowledge on the different dimensions of work ability is necessary for regaining, maintaining and promoting work ability. The purpose of this book is to provide a comprehensive overview of the work ability of the Finnish population. The book is based on the extensive data of the Finnish Health 2000 Survey. The focus is on the age group of 30 to 64 years; young adults and over 64-year-olds are addressed more briefly. The number of the 30- to 64-year-old participants was 5,199. Most people of working age evaluated their work ability as good. Well- educated persons, white-collar workers and those living with families were most satisfied with their work ability whereas farmers, part-time workers and unem- ployed people often perceived their work ability to be limited. In all population groups work ability decreased with growing age. The oldest group of employed women, in particular, had many problems with work ability. Among young adults, the highest risks of limited work ability were unemployment, lack of sufficient basic education and mental problems. Health and work were the most important determinants of work ability. Of the diseases investigated in this study, depression and back disorders decreased the work ability of employed people the most. Yet, also among those with no long-term illnesses, limitations in work ability increased with age. Low physical work demands, support from supervisors and co-workers, control over one’s work, and possibilities of development at work were related to good work ability. A suitable job seemed to ensure maintenance of work ability also among older workers. In addition to work and health also expertise, skills and attitudes defined work ability. The relation of expertise to good work ability was, however, evident only among those with a higher education, a physically light job and good health. A comparison with the data of the Mini-Finland Survey that was carried out at the end of the 1970s showed that work ability of the population had improved over a period of two decades. The simultaneous change in the population’s edu- cational level explained the decrease in work ability limitations among women and for the most part among men. Dimensions_of_Work_Ability.indb 5 23.4.2008 13:18:49 Dimensions_of_Work_Ability.indb 6 23.4.2008 13:18:49 Contents Raija Gould, Juhani Ilmarinen, Jorma Järvisalo, Seppo Koskinen 1 Introduction ..........................................................................................11 Juhani Ilmarinen, Raija Gould, Aila Järvikoski, Jorma Järvisalo 2 Diversity of Work Ability ....................................................................13 2.1 Work ability concept ....................................................................14 2.2 Models for work ability and its promotion ..................................15 2.3 Evaluation and measurement of work ability ..............................22 2.4 Work ability in this study .............................................................23 Raija Gould, Seppo Koskinen, Jorma Seitsamo, Kaija Tuomi, Anu Polvinen, Päivi Sainio 3 Data and Methods ................................................................................25 3.1 Study population ..........................................................................25 3.2 Work ability indicators ................................................................27 3.3 Statistical methods .......................................................................32 4 Work Ability in Different Population Groups ...................................33 Raija Gould, Anu Polvinen, Jorma Seitsamo 4.1 Age and gender ............................................................................35 Tuija Martelin, Päivi Sainio, Seppo Koskinen, Raija Gould 4.2 Region ..........................................................................................39 Tuija Martelin, Päivi Sainio, Seppo Koskinen, Raija Gould 4.3 Education .....................................................................................42 Tuija Martelin, Päivi Sainio, Seppo Koskinen, Raija Gould 4.4 Employment status .......................................................................45 Raija Gould, Anu Polvinen 4.5 Occupation ...................................................................................48 Tiina Pensola, Aila Järvikoski 4.6 Marital status ................................................................................54 Raija Gould, Tuija Martelin, Seppo Koskinen, Päivi Sainio 4.7 Summary and conclusions ...........................................................57 Dimensions_of_Work_Ability.indb 7 23.4.2008 13:18:49 5 Factors Affecting Work Ability ...........................................................63 Seppo Koskinen, Tuija Martelin, Päivi Sainio, Raija Gould 5.1 Health ...........................................................................................65 5.1.1 Perceived health and long-term morbidity ................................ 66 5.1.2 Cardiovascular diseases and diabetes