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The contribution of work and health-related lifestyle to educational inequalities in physical health among older workers in Germany. A causal mediation analysis with data from the lidA cohort study

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  • Max Rohrbacher
  • Hans Martin Hasselhorn

Abstract

Objectives: The objective of the study was to investigate the contribution of work factors and health-related lifestyle to educational inequalities in physical health among older workers in Germany by applying causal mediation analysis with longitudinal data. Methods: Data from the German lidA study was used. 2653 persons (53% female, 47% male) aged 46 (born 1965) and 52 (born 1959) at baseline were followed up for seven years with exposure and outcome assessments in 2011 (t0), 2014 (t1) and 2018 (t2). The total effect of education on physical health was decomposed into a natural direct effect (NDE) and a natural indirect effect (NIE) by using a sex-stratified causal mediation analysis with an inverse odds weighting approach. Baseline health, partner status and working hours were entered as a first set of mediators preceding the putative mediators of interest. All analyses were adjusted for age and migrant status. Results: Independent of the first set of mediators, work factors explained 21% of educational inequalities in physical health between low and high educated women and 0% comparing moderate versus high educated women. The addition of health behaviors explained further 26% (low vs. high education) and 20% (moderate vs. high education), respectively. Among men, net of the first set of mediators, work factors explained 5% of educational inequalities in physical health between low and high educated and 6% comparing moderate versus high educated persons. Additional 24% (low vs. high education) and 27% (moderate vs. high education) were explained by adding health behaviors to the models. Conclusions: To reduce educational inequalities in physical health among older workers in Germany, interventions to promote healthy behaviors are promising. Improving working conditions is likely an important prerequisite.

Suggested Citation

  • Max Rohrbacher & Hans Martin Hasselhorn, 2023. "The contribution of work and health-related lifestyle to educational inequalities in physical health among older workers in Germany. A causal mediation analysis with data from the lidA cohort study," PLOS ONE, Public Library of Science, vol. 18(8), pages 1-22, August.
    • Handle: RePEc:plo:pone00:0285319
    DOI: 10.1371/journal.pone.0285319
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    References listed on IDEAS

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    1. Duncan, G.J. & Daly, M.C. & McDonough, P. & Williams, D.R., 2002. "Optimal indicators of socioeconomic status for health research," American Journal of Public Health, American Public Health Association, vol. 92(7), pages 1151-1157.
    2. Schröder, Helmut & Kersting, Anne & Gilberg, Reiner & Steinwede, Jacob, 2013. "Methodenbericht zur Haupterhebung lidA - leben in der Arbeit," FDZ Methodenreport 201301_de, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany].
    3. Lahelma, Eero & Laaksonen, Mikko & Martikainen, Pekka & Rahkonen, Ossi & Sarlio-Lähteenkorva, Sirpa, 2006. "Multiple measures of socioeconomic circumstances and common mental disorders," Social Science & Medicine, Elsevier, vol. 63(5), pages 1383-1399, September.
    4. repec:iab:iabfme:201301(de is not listed on IDEAS
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