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• W3083954005 abstract "BACKGROUND: Employment is the most important source of financial income and material well-being and therefore is the main driver of the social gradient in physical health, mental health, and mortality. In addition, good employment fulfils psychosocial needs and is fundamental for an individual’s social status, societal participation, and identity. However, work participation is known to fall steeply after the age of 50 in women and 55 in men. In the EU, musculoskeletal disorders (MSDs) account for 50% of all absences from work lasting 3 days or longer and for 60% of all permanent work incapacity. However, in those aged over 50, MSDs also commonly co-occur with other health conditions, in what is known as multimorbidity. AIMS: the overarching aims of this thesis are to investigate, among older working-aged people, a) the impact of common comorbid health conditions on work outcomes in people with MSDs, and b) the common patterns of multimorbidity and their contribution to health-related job loss. METHODS: Chapter four is a systematic review of the impact of comorbidity on work outcomes in people with musculoskeletal disease. The chapters that follow describe results from a nested matched case-control study of working-age participants, over the age of fifty. Health and Employment After Fifty (HEAF) study participants with health-related job loss (HRJL) were matched 1:1 to working control participants for age, sex, and GP practice. Participants’ health diagnoses at the time of HRJL were extracted using retrospective data from the Clinical Practice Research Datalink (CPRD). Chapter five describes a cohort of older workers with HRJL (case participants) for their known demographic, lifestyle, occupational, and health factors. Chapter six compares case participants to working controls for CPRD-defined health disorders to assess their association with HRJL. Chapter seven uses cluster analysis to describe common patterns of multimorbidity across the total study sample. In Chapter eight, these prominent clusters of health disorders were explored for their association with HRJL. Finally, in Chapter nine, multivariable conditional logistic models were constructed using purposeful selection to explore the population attributable fraction of HRJL for CPRD-defined health disorders. CONCLUSIONS: Results supported the primary importance of common mental health problems and musculoskeletal disorders for health-related job loss in the older working-age population. However, multimorbidity (classified as two or more CPRD-defined health disorders) was strongly associated with HRJL and accounted for a significantly greater proportion of HRJL than any individual health disorder. Multimorbidity clusters formed by co-occurring musculoskeletal disorders and mental health problems appeared to have a particularly strong impact on HRJL." @default.
• W3083954005 created "2020-09-14" @default.
• W3083954005 creator A5085088354 @default.
• W3083954005 date "2020-05-30" @default.
• W3083954005 modified "2023-09-23" @default.
• W3083954005 title "The contribution of musculoskeletal disorders and multimorbidity to health-related job loss among older working-age adults: a population-based study" @default.
• W3083954005 doi "https://doi.org/10.17638/03089220" @default.
• W3083954005 hasPublicationYear "2020" @default.
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