IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0285319.html
   My bibliography  Save this article

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

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0285319
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0285319&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0285319?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    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
    5. Duncan, G.J. & Daly, M.C. & McDonogh, P. & Williams, D.R., 2002. "Erratum: Optimal indicators of socioeconomic status for health research (American Journal of Public Health (2002) 92 (1151-1157))," American Journal of Public Health, American Public Health Association, vol. 92(8), pages 1212-1212.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Vanessa Tan & Cynthia Chen & Reshma Aziz Merchant, 2022. "Association of social determinants of health with frailty, cognitive impairment, and self-rated health among older adults," PLOS ONE, Public Library of Science, vol. 17(11), pages 1-18, November.
    2. Kino, Shiho & Jang, Soong-nang & Takahashi, Shuko & Ebner, Daniel K. & Kawachi, Ichiro, 2020. "Socioeconomic disparities in self-rated health in two East Asian countries: Comparative study between Japan and Korea," Social Science & Medicine, Elsevier, vol. 253(C).
    3. Garbarski, Dana, 2010. "Perceived social position and health: Is there a reciprocal relationship?," Social Science & Medicine, Elsevier, vol. 70(5), pages 692-699, March.
    4. Smith, Kimberly V. & Goldman, Noreen, 2007. "Socioeconomic differences in health among older adults in Mexico," Social Science & Medicine, Elsevier, vol. 65(7), pages 1372-1385, October.
    5. Naz Onel & Avinandan Mukherjee, 2014. "The effects of national culture and human development on environmental health," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 16(1), pages 79-101, February.
    6. Samuel H. Fishman, 2025. "Occupational Status and Health in Early Midlife," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 44(1), pages 1-27, February.
    7. Roberto A. Trevino & Alan J. Richard, 2012. "Public Funding and Affordability of Substance Abuse Treatment Services," American Journal of Economics and Business Administration, Science Publications, vol. 4(1), pages 72-83, February.
    8. Jibum Kim & Jinkook Lee, 2010. "Disability of Older Koreans Evidence on Prevalence and the Role of Education from Five Data Sets," Working Papers WR-811, RAND Corporation.
    9. D. Cooper & W. D. McCausland & I. Theodossiou, 2008. "Unemployed, uneducated and sick: the effects of socio‐economic status on health duration in the European Union," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 171(4), pages 939-952, October.
    10. Brady, David & Curran, Michaela & Carpiano, Richard M., 2023. "A test of the predictive validity of relative versus absolute income for self-reported health and well-being in the United States," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 48, pages 775-808.
    11. Brady, David & Gao, Manjing & Guerra, Christian & Kohler, Ulrich & Link, Bruce, 2024. "The long term relationship between childhood Medicaid expansions and severe chronic conditions in adulthood," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 58(1), pages 39-60.
    12. Steven Prus, 2007. "Age, SES, and Health: A Population Level Analysis of Health Inequalities over the Life Course," Social and Economic Dimensions of an Aging Population Research Papers 181, McMaster University.
    13. Mackenbach, Johan P. & Kulhánová, Ivana & Bopp, Matthias & Deboosere, Patrick & Eikemo, Terje A. & Hoffmann, Rasmus & Kulik, Margarete C. & Leinsalu, Mall & Martikainen, Pekka & Menvielle, Gwenn & Reg, 2015. "Variations in the relation between education and cause-specific mortality in 19 European populations: A test of the “fundamental causes” theory of social inequalities in health," Social Science & Medicine, Elsevier, vol. 127(C), pages 51-62.
    14. Neil T Coffee & Tony Lockwood & Peter Rossini & Theo Niyonsenga & Stanley McGreal, 2020. "Composition and context drivers of residential property location value as a socioeconomic status measure," Environment and Planning B, , vol. 47(5), pages 790-807, June.
    15. Malene Kallestrup‐Lamb & Søren Kjærgaard & Carsten P. T. Rosenskjold, 2020. "Insight into stagnating adult life expectancy: Analyzing cause of death patterns across socioeconomic groups," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1728-1743, December.
    16. Nina Cesare & Pallavi Dwivedi & Quynh C. Nguyen & Elaine O. Nsoesie, 2019. "Use of social media, search queries, and demographic data to assess obesity prevalence in the United States," Palgrave Communications, Palgrave Macmillan, vol. 5(1), pages 1-9, December.
    17. Zhifei He & Zhaohui Cheng & Ghose Bishwajit & Dongsheng Zou, 2018. "Wealth Inequality as a Predictor of Subjective Health, Happiness and Life Satisfaction among Nepalese Women," IJERPH, MDPI, vol. 15(12), pages 1-11, December.
    18. Stefanie Mollborn & Elizabeth Lawrence & Laurie James-Hawkins & Paula Fomby, 2014. "How Resource Dynamics Explain Accumulating Developmental and Health Disparities for Teen Parents’ Children," Demography, Springer;Population Association of America (PAA), vol. 51(4), pages 1199-1224, August.
    19. Hoffmann, Rasmus & Kröger, Hannes & Tarkiainen, Lasse & Martikainen, Pekka, 2019. "Dimensions of Social Stratification and Their Relation to Mortality: A Comparison Across Gender and Life Course Periods in Finland," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 145(1), pages 349-365.
    20. Christopher J. Boyce & Andrew J. Oswald, 2012. "Do people become healthier after being promoted?," Health Economics, John Wiley & Sons, Ltd., vol. 21(5), pages 580-596, May.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0285319. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.