title: Associations between work-related stress in late midlife, educational attainment, and serious health problems in old age: a longitudinal study with over 20 years of follow-up.
abstract: BACKGROUND
  People spend a considerable amount of time at work over the course of their lives, which makes the workplace important to health and aging. However, little is known about the potential long-term effects of work-related stress on late-life health. This study aims to examine work-related stress in late midlife and educational attainment in relation to serious health problems in old age.
  
  
  METHODS
  Data from nationally representative Swedish surveys were used in the analyses (n = 1,502). Follow-up time was 20-24 years. Logistic regressions were used to examine work-related stress (self-reported job demands, job control, and job strain) in relation to serious health problems measured as none, serious problems in one health domain, and serious problems in two or three health domains (complex health problems).
  
  
  RESULTS
  While not all results were statistically significant, high job demands were associated with higher odds of serious health problems among women but lower odds of serious health problems among men. Job control was negatively associated with serious health problems. The strongest association in this study was between high job strain and complex health problems. After adjustment for educational attainment some of the associations became statistically nonsignificant. However, high job demands, remained related to lower odds of serious problems in one health domain among men, and low job control remained associated with higher odds of complex health problems among men. High job demands were associated with lower odds of complex health problems among men with low education, but not among men with high education, or among women regardless of level of education.
  
  
  CONCLUSIONS
  The results underscore the importance of work-related stress for long-term health. Modification to work environment to reduce work stress (e.g., providing opportunities for self-direction/monitoring levels of psychological job demands) may serve as a springboard for the development of preventive strategies to improve public health both before and after retirement.
authors.affiliation: Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden. charlotta.nilsen@ki.se.
authors.forename: Charlotta
authors.initials: C
authors.lastname: Nilsen
authors.forename: Ross
authors.initials: R
authors.lastname: Andel
authors.forename: Stefan
authors.initials: S
authors.lastname: Fors
authors.forename: Bettina
authors.initials: B
authors.lastname: Meinow
authors.forename: Alexander
authors.initials: A
authors.lastname: Darin Mattsson
authors.forename: Ingemar
authors.initials: I
authors.lastname: Kåreholt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006299:Health Services for the Aged; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D012737:Sex Factors; D013315:Stress, Psychological / Q000523:psychology*; D013548:Sweden; D014937:Work / Q000523:psychology*