Objective To determine the associations between different measures of health and labor market position across ten European countries. Methods We studied 11,462 participants of the Survey on Health and Ageing in Europe (SHARE) who were 50–64 years old. Logistic regression was used to calculate the associations between health and other determinants and being retired, unemployed, or a homemaker. Results A large variation across European countries was observed for the proportion of persons 50–65 years with paid employment, varying among men from 42% in Austria to 75% in Sweden and among women from 22% in Italy to 69% in Sweden. Among employed workers 18% reported a poor health, whereas this proportion was 37% in retirees, 39% in unemployed persons, and 35% in homemakers. A perceived poor health was strongly associated with non-participating in labor force in most European countries. A lower education, being single, physical inactivity and a high body mass index were associated with withdrawal from the labor force. Long-term illnesses such as depression, stroke, diabetes, chronic lung disease, and musculoskeletal disease were significantly more common among those persons not having paid employment. Conclusion In many European countries a poor health, chronic diseases, and lifestyle factors were associated with being out of the labor market. The results of this study suggest that in social policies to encourage employment among older persons the role of ill-health and its influencing factors needs to be incorporated.

Background Maintaining the ability of workers to cope with physical and psychosocial demands at work becomes increasingly important in prolonging working life.

Objectives The purpose of this article is to explore the associations of psychosocial factors at work, life style, and stressful life events on health and work ability among white-collar workers. Methods A cross-sectional survey was conducted among workers in commercial services (n = 1141). The main outcome variables were work ability, measured by the work ability index (WAI), and mental and physical health, measured by the Short-Form Health Survey (SF-12). Individual characteristics, psychosocial factors at work, stressful life events, and lifestyle factors were determined by a questionnaire. Maximum oxygen uptake, weight, height, and biceps strength were measured during a physical examination. Results Work ability of white-collar workers in commercial services industry was strongly associated with psychosocial factors at work such as teamwork, stress handling, and self-development and, to a lesser extent, with stressful life events, lack of physical activity, and obesity. Determinants of mental health were very similar to those of work ability, whereas physical health was influenced primarily by life style factors. With respect to work ability, the influence of unhealthy life style seems more important for older workers, than for their younger colleagues. Conclusion Among white-collar workers mental and physical health were of equal importance to work ability, but only mental health and work ability shared the same determinants. The strong associations between psychosocial factors at work and mental health and work ability suggest that in this study population health promotion should address working conditions rather than individual life style factors.

Background: Approximately 10% to 20% of people with concussion experience prolonged post-concussion symptoms (PPCS). There is limited information identifying risk factors for PPCS in adult populations. This study aimed to derive a risk score for PPCS by determining which demographic factors, premorbid health conditions, and healthcare utilization patterns are associated with need for prolonged concussion care among a large cohort of adults with concussion. Methods and findings: Data from a cohort study (Ontario Concussion Cohort study, 2008 to 2016; n = 1,330,336) including all adults with a concussion diagnosis by either primary care physician (ICD-9 code 850) or in emergency department (ICD-10 code S06) and 2 years of healthcare tracking postinjury (2008 to 2014, n = 587,057) were used in a retrospective analysis. Approximately 42.4% of the cohort was female, and adults between 18 and 30 years was the largest age group (31.0%). PPCS was defined as 2 or more specialist visits for concussion-related symptoms more than 6 months after injury index date. Approximately 13% (73,122) of the cohort had PPCS. Total cohort was divided into Derivation (2009 to 2013, n = 417,335) and Validation cohorts (2009 and 2014, n = 169,722) based upon injury index year. Variables selected a priori such as psychiatric disorders, migraines, sleep disorders, demographic factors, and pre-injury healthcare patterns were entered into multivariable logistic regression and CART modeling in the Derivation Cohort to calculate PPCS estimates and forward selection logistic regression model in the Validation Cohort. Variables with the highest probability of PPCS derived in the Derivation Cohort were: Age >61 years ( p^ = 0.54), bipolar disorder ( p^ = 0.52), high pre-injury primary care visits per year ( p^ = 0.46), personality disorders ( p^ = 0.45), and anxiety and depression ( p^ = 0.33). The area under the curve (AUC) was 0.79 for the derivation model, 0.79 for bootstrap internal validation of the Derivation Cohort, and 0.64 for the Validation model. A limitation of this study was ability to track healthcare usage only to healthcare providers that submit to Ontario Health Insurance Plan (OHIP); thus, some patients seeking treatment for prolonged symptoms may not be captured in this analysis. Conclusions: In this study, we observed that premorbid psychiatric conditions, pre-injury health system usage, and older age were associated with increased risk of a prolonged recovery from concussion. This risk score allows clinicians to calculate an individual’s risk of requiring treatment more than 6 months post-concussion.