Factors affecting work ability and influencing early retirement decisions of older employees: an attempt to integrate the existing approaches.

The article has several objectives. First, it aims to discuss, based on the international literature analysis, theoretical models and factors influencing early retirement decisions, and limiting work ability and employability of older people. Second, the concept of (and the factors related to) work ability as well as the role of age management in improving employability and sustaining work activity of older adults are analyzed against the backdrop of the Polish context. Cultural (ageism) and organizational (e.g., a lack of appropriate age management in companies) factors influencing work activity in the oldest age groups are taken into account. Third, the authors present some solutions and recommendations coming from the international Participation To Healthy Workplaces And inclusive Strategies in the Work Sector (PATHWAYS) project. Finally, theoretical models, concepts and solutions are integrated into a model elucidating the conditions (cultural, social, organizational, individual) influencing work ability of older adults. The model aims to take into account theories and factors identified in the literature review and grouped into several categories. The analysis highlights the role of appropriate age management in companies in the process of sustaining work ability of older employees. Int J Occup Med Environ Health. 2022;35(5):509-26.

Values and preferences influencing willingness to change red and processed meat consumption in response to evidence-based information: a mixed methods study.

OBJECTIVES: (1) to assess the extent to which omnivores are willing to stop or reduce their consumption of red and processed meat in response to evidence-based information regarding the possible reduction of cancer mortality and incidence achieved by dietary modification; (2) to identify sociodemographic categories associated with higher willingness to change meat consumption; (3) to understand the motives facilitating and hindering such a change. DESIGN: During an initial computer-assisted web interview, respondents were presented with scenarios containing the estimates of the absolute risk reduction in overall cancer incidence and mortality tailored to their declared level of red and processed meat consumption. Respondents were asked whether they would stop or reduce their average meat consumption based on the information provided. Their dietary choices were assessed at 6-month follow-up. Additionally, we conducted semi-structured interviews to better understand the rationale for dietary practices and the perception of health information. PARTICIPANTS: The study was conducted among students and staff of 3 universities in Krakow, Poland. RESULTS: Most of the 513 respondents were unwilling to change their consumption habits. We found gender to be a significant predictor of the willingness. Finally, we identified 4 themes reflecting key motives that determined meat consumption preferences: the importance of taste and texture, health consciousness, the habitual nature of cooking, and persistence of omnivorous habits. CONCLUSIONS: When faced with health information about the uncertain reduction in the risk of cancer mortality and incidence, the vast majority of study participants were unwilling to introduce changes in their consumption habits.

Difficult entry and return to the labor market: on the professional (re)integration of people with disabilities and chronic health conditions in Poland (The PATHWAYS research project)

Objectives: The objective of this study is to present the barriers existing in Poland to professional integration and reintegration of people with chronic diseases, including mental health conditions, and discuss them on the basis of expert opinions and in comparison with the situation in other European countries. Material and Methods: The research methodology was based on a mixed-methods approach, including literature review, in-depth expert interviews, and a survey (based on a structured questionnaire) performed with experts. Results: The mapping of policies, systems and services facilitating the integration and reintegration of people with chronic diseases in Poland, as well as expert opinions, made it possible to identify many barriers regarding access to support, such as an obligation to have a certificate of disability, and a system of certification by 2 institutions. There are also barriers regarding the support itself, including problems with subsidies and with professional (re)integration services. Conclusions: Poland has a multi-level and multi-sector system of public institutions, which should provide support for people with disabilities and chronic diseases. Nevertheless, the research conducted in Poland indicates an insufficient implementation of the existing solutions. Int J Occup Med Environ Health. 2019;32(4):475­88

Sleep duration and mortality among older adults in a 22-year follow-up study: an analysis of possible effect modifiers.

The aim of this study was to assess the relationship of sleep duration and all-cause mortality among 2,449 Polish community-dwelling older citizens of Krakow observed during 22 years of follow-up. In particular, the role of some demographic, psychosocial and health-related conditions were investigated in terms of modification effect. In the prospective study, background information was gathered by face-to-face interview. Vital data were obtained from the population registry. Cox regression models were used to assess the role of sleep duration in mortality, in the analyses of potential effect modifiers and the shape of the relationship. Sleep duration was observed to be a significant predictor of all-cause mortality. Life-weariness, functional activity, total number of chronic diseases and age (65-79, 80+) were found to be effect modifiers for the relationship between sleep duration and mortality. Further investigation showed a U-shaped mortality risk associated with the duration of sleep among individuals with a high level of life-weariness, high functional activity and in individuals aged 80 and over. On the other hand, a linear relationship between longer sleep duration and mortality was observed among older people with no experience of life-weariness, without chronic diseases, with medium functional activity and aged 65-79, but also among those who reported three and more chronic conditions. Results of our study support available evidence showing the relationship between sleep duration and mortality among older adults and suggest that any public health intervention in this area should consider also other coexisting modifiable psychosocial and functional determinants.

Health-related quality of life in older age and a risk of being a victim of domestic violence.

Violence against older people remains a taboo topic in Poland, and is still an under-recognized phenomenon. The aim of this study was to examine the risk of different types of domestic violence in older people in relation to their health-related quality of life as measured by chronic conditions, functional limitations, psychological well-being, depressive symptoms and feelings of social isolation. A cross-sectional study using a standardized questionnaire in a simple random sample of 518 older citizens of Krakow was carried out. A multidimensional logistic regression of data showed that such factors as poor assessment of psychological health, number of chronic conditions, suffering from emotional and social loneliness and lack of social support in everyday life significantly increased the risk of being a victim of domestic violence in older citizens of Krakow.

Job stress and mortality in older age.

OBJECTIVES: This paper aims to assess the relationship between the determinants of the psychosocial work environment, as expressed in terms of JDC or ERI models, and all-cause mortality in older individuals. MATERIALS AND METHODS: The baseline study was conducted on a cohort comprising a random sample of 65-year-old community-dwelling citizens of Kraków, Poland. All of the 727 participants (410 women, 317 men) were interviewed in their households in the period between 2001 and 2003; a structured questionnaire was used regarding their occupational activity history, which included indexes measuring particular dimensions of their psychosocial work environment based on Karasek's Job Demand-Control model and Siegrist's Effort-Reward Imbalance model, as well as health-related quality of life and demographic data. Mortality was ascertained by monitoring City Vital Records for 7 years. Analyses were conducted separately for men and women, with the multivariate Cox proportional hazard model. RESULTS: During a 7-year follow-up period, 59 participants (8.1%) died, including 21 women (5.1% of total women) and 38 men (12%) (p < 0.05). Significant differences in the number of deaths occurred regarding disproportion between physical demands and control in men: those with low physical demands and low control died three times more often than those with high control, regardless of the level of demands. The multivariate Cox proportional hazard model showed that significantly higher risk of death was observed only in men with low physical demands and low control, compared to those with low physical demands and high control (Exp(B) = 4.65, 95% CI: 1.64-13.2). CONCLUSIONS: Observed differences in mortality patterns are similar to the patterns of relationships observed in health-related quality of life (HRQoL) level at the beginning of old age; however, the relationship between efforts and rewards or demands and control and mortality was not fully confirmed.

The role of different predictors in 20-year mortality among Krakow older citizens.

BACKGROUND: The aim of this study was to assess the change in the predictive ability of gender-related 20-year all-cause mortality in community-dwelling older people. METHODS: The baseline investigation was conducted in 1986-1987 and survival of 2472 subjects aged 65 years and older was followed up for 20 years. The associations of socioeconomic conditions and health measures with mortality were assessed using Cox hazard model with time-dependent covariates. RESULTS: Our study confirmed that higher education and being employed during the baseline were protective factors in males, but not among females. Healthy lifestyle was a predictive factor for all-cause mortality for both men and women and its predictive value was strong over the whole observation period. The study showed that poor self-rated health (SRH) was a valid predictor of mortality in elderly women, but not in men, and the effect of the length of follow-up on mortality was not observed. Overall, different sets of all-cause mortality predictors were found for men and women. For men the role of socioeconomic status factors was confirmed as well as healthy lifestyle and presence of chronic conditions, especially coronary heart disease (CHD) and asthma. For women the most important predictors were lifestyle factors and the feeling of life-weariness as well as SRH and diabetes mellitus present during the baseline study. CONCLUSIONS: The impact of most of the examined factors on mortality was found to be stable over the twenty years of observation with the exception of the self-reported CHD, whose predictive value decreased over time.

The current state and challenges for the future of health promotion in Polish older people.

OBJECTIVE: Still in its early stages, much work remains to be done in terms of the health promotion of older people in Poland. The aim of this paper is to present the current state of health promotion in older people in Poland on the basis of research conducted within the framework of the healthPROelderly project, presenting the state of health promotion in older people after 1989, and to provide practical recommendations for future interventions. METHODS: (1) Content analysis of scientific and popular publications; (2) document analysis of policy papers; (3) review of existing Polish health promotion programs; (4) program case studies; (5) SWOT analysis of the state of health promotion in Poland. RESULTS: In the past 10 years, in terms of planning and realization, efforts aimed at health promotion in older people were only sporadically realized. There were no macrostructural programs targeting this age group nor was this an element of national health policy. Only a small number of health promotion programs targeting older people were found. CONCLUSIONS: There should be a renewed focus on health promotion, as opposed to preventing disease. Health promotion campaigns should target those with a decreased awareness of their health needs, with improvement in health status being based on increasing this awareness. In an effort to develop more health-conscious attitudes and behaviors in older age, health promotion initiatives should also be marketed to pre-retirement aged individuals.