Quality of life, work ability and self-employment: a population survey of entrepreneurs, farmers and salary- earners

Abstract

Objectives: Self-employment is increasing but it is not yet known how its different forms affect health, quality of life and work ability. We compared the work ability, subjective quality of life (QoL) and health-related quality of life (HRQoL) of entrepreneurs both with and without personnel, farmers and salaried workers. We investigated which domains of HRQoL associate with work status. Methods: A nationally representative general population sample comprising 5 834 Finns aged between 30 and 64. Work ability was measured using the Work Ability Index (WAI), HRQoL using 15D and EQ-5D, and QoL with self-reported global quality of life. Results: Entrepreneurs with personnel had better work ability than salary-earners, but there were no differences in QoL or HRQoL between the entrepreneurs and salary-earners. Farmers scored lowest on all measures; this finding remained even after adjusting for age, gender, marital status, education and chronic conditions. The low WAI score of farmers was mainly explained by poor subjective work ability, while their low 15D score was mainly due to poor functioning in the psychosocial domains of HRQoL. The low EQ-5D score of farmers was explained by problems with mobility, usual activities and with pain or discomfort. Conclusions: Farmers have poorer work ability, QoL and HRQoL than other working groups, but this does not appear to be due to physical health problems. From research point of view, farmers should be categorized separately from other forms of entrepreneurship. From a public health point of view, improving farmers well-being may require psychosocial interventions exceeding traditional health promotion.