The good news is that the numbers of disability pensions and long periods of sick leave are down in Finland. According to Jukka Uitti, professor of occupational health and health care at the University of Tampere, this means that workplaces have taken the right measures.
“The Finnish Working Life Barometer and several other studies show that the health of employees has greatly improved in recent decades,” Uitti says.
Surprisingly, even stress levels have been reduced.
“When you follow the media, you might get the impression that stress and other forms of psychological ill health are increasing, but this is not corroborated by research findings.”
Uitti states that the positive developments result from improvements in working conditions and work environments, and the development of supervision and management. Partial work ability is also more highly appreciated these days, signifying a major change in attitudes.
Work ability refers to a person’s functional ability and resources to meet the demands of work.
“Not that long ago, it was estimated that 15–18 per cent of disability pensions were caused by employees queuing up for medical check-ups, appointments with a psychiatrist or operations. Nobody provided them with health care while they were in the queues. We have advanced from that kind of thinking to a new perspective – that people can work even if they are being treated for medical conditions.”
Societal debate on preventing disability often concentrates on financial savings, but Uitti dislikes discourse that only focuses on economic reasons.
“The most important thing is to adjust the work and to treat and rehabilitate the employee so that he or she is happy to continue working.”
A long term follow-up study conducted by the Universities of Tampere and Jyväskylä and the Finnish Institute of Occupational Health has concluded that work ability in mid-life predicts how well people do after they retire.
Both physical and mental strain have long-term effects that manifest themselves in functional ability well into retirement. If a person’s work ability is good in middle age, it is very likely that his or her functional ability will also be good even as long as thirty years later. Work ability has also been shown to predict mortality.
“How people experience their work ability in middle age is a good predictor of how well they will fare in old age,” says Clas-Håkan Nygård, professor of occupational health at the University of Tampere.
In 1980, the Finnish Longitudinal Study of Municipal Employees (FLAME) started a follow-up on a group of over 6,000 municipal employees. At the time the study started, the employees were middle-aged, and the follow-up is still going on today. The research has provided invaluable information on what happens towards the end of people’s careers and what effect mid-life health has on functional ability in old age. The research also looked at the effect of hobbies and free time on health.
With funding from Kela – the Finnish national insurance institution – the researchers are currently conducting a study on disability pensions using the same data.
It has also become evident that disability can be predicted on the basis of how people feel in mid-life. Almost seventy per cent of the middle-aged people who reported having poor work ability were either on a disability pension or dead within eleven years.
By contrast, only about 5–10 per cent of the people who said that they had good work ability were no longer working after eleven years.
“Work ability should be developed throughout a person’s career. This seems obvious from the employers’ perspective, but retaining work ability is also important for public health reasons. That is the important message,” Nygård says.
Most 50-year-olds already suffer from some chronic diseases, but these illnesses will not reduce work ability if they are properly treated.
In other words, good work ability predicts a healthier old age and reduces the need for health and social services.
“People’s lives are getting longer, generation by generation. Do we want to add good or bad years? This is something that can be influenced at working age,” Uitti explains.
“Administrative solutions as such are insufficient, even though we need those, too. Above all, we need to combine the processes of the different actors. We need a common goal, i.e. promoting work ability by matching the work to the worker or, when necessary, retraining the worker.”
Text: Tiina Lankinen
Illustration: Jonne Renvall