Work conditions are associated with physical health in later life: a longitudinal cohort study in Taiwan

Work occupies a significant portion of adult life, and work conditions are associated with health among workers. This study examined the association between work conditions and mortality, heart disease, stroke, osteoporosis or osteoporotic fracture, and frailty in later life.

This study included a cohort of 4,192 community-dwelling adults ≥55 years old. A matrix of work conditions by occupation was constructed using a representative national survey in Taiwan. Psychosocial work conditions were assessed using the Job Content Questionnaire, focusing on job control and psychological demands. Mortality and physical morbidity were identified through physician diagnoses recorded in the National Health Insurance Database.

During 10 years of follow-up, 25.0% of the participants died, and 14.2% were diagnosed with heart disease, 17.6% with stroke, 19.4% with osteoporosis or osteoporotic fractures, and 48.66% with frailty. After adjusting for confounding factors, high-skill-discretion jobs (vs low) were associated with a 0.84-fold hazard of mortality (95% confidence interval [CI]: 0.73-0.97), a 0.60-fold hazard of hemorrhagic stroke (95% CI: 0.40-0.90), a 0.79-fold lower hazard of heart disease (95% CI: 0.64-0.97), and a lower multimorbidity frailty index (95% CI: -7.75 to -2.49). Additionally, high psychological demands (vs low) were associated with a 0.85-fold risk of mortality (95% CI: 0.75-0.97) and osteoporosis or osteoporotic fractures (95% CI: 0.73-0.99).

High skill utilization and psychological demands were associated with reduced risks of mortality and morbidity in later life. Decent working conditions constitute a modifiable factor that supports healthy aging.