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Who maintains good health functioning? The contribution of social, work-related and behavioural factors to mental and physical health functioning trajectories in ageing employees
  1. Tea Lallukka1,2,
  2. Aapo Hiilamo2,
  3. Olli Pietiläinen1,
  4. Minna Mänty3,
  5. Anne Kouvonen4,5,
  6. Ossi Rahkonen1
  1. 1 Department of Public Health, University of Helsinki, Helsinki, Finland
  2. 2 Finnish Institute of Occupational Health, Helsinki, Finland
  3. 3 City of Vantaa, Vantaa, Finland
  4. 4 Faculty of Social Sciences, Helsingin Yliopisto, Helsinki, Finland
  5. 5 Queen's University Belfast, Belfast, UK
  1. Correspondence to Professor Tea Lallukka, Department of Public Health, University of Helsinki, Helsinki, Finland; tea.lallukka{at}


Objectives The determinants of poor functioning and subsequent early exit from work are well established but very little is known about the positive determinants of maintaining good functioning among the ageing workforce. We investigated modifiable determinants of maintaining good mental and physical health functioning.

Methods We used prospective survey data collected across four waves among the midlife employees of the City of Helsinki, Finland, 2000–2017 (n=3342). Health functioning was repeatedly measured using the Short Form 36 (SF-36) inventory. Trajectories of mental and physical health functioning were separately examined using group-based trajectory analysis. Multinomial logistic regression models were fitted to examine determinants of each trajectory.

Results Four trajectory solutions for the developmental patterns in health functioning during the follow-up period were selected, with a slightly different shape of the first trajectory for mental and physical functioning: (1) continuously low (mental), low and decreasing (physical), (2) increasing, (3) decreasing and (4) continuously high functioning. After adjustments, the employees in the continuously high mental health functioning group were more likely to have optimal job demands, high job control, no sleep problems and no binge drinking behaviour. Employees in the continuously high physical functioning group had more likely low levels of physically strenuous work and hazardous working environment and no sleep problems and normal weight.

Conclusion High job control, good sleep and avoiding binge drinking may help maintain good mental health functioning. Low levels of physical or environmental work exposures, good sleep and recommended healthy weight may support maintenance of good physical health functioning among ageing employees.

  • quality of life
  • workload
  • epidemiology
  • public health
  • sleep

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  • Contributors TL and AH conceived and designed the study, and AH analysed the data. TL prepared the first version of the manuscript. AH helped draft the manuscript. All authors (TL, AH, OP, MM, AK and OR) discussed the results and commented on the manuscript, and approved the submission of the final version.

  • Funding This work was supported by the Finnish Work Environment Fund (Grant #117308) and by the Academy of Finland (Grants #287488, #319200 for TL and AH, grant #1294514 for OR). AK is supported by the Economic and Social Research Council (ESRC) (Grant ES/S00744X/1).

  • Competing interests TL has received a lecture fee from an Insurance Company LähiTapiola, regarding an invited talk in a seminar (in Finnish) they funded with another company Elo. The talk was about pain and work ability, and an overall talk, i.e., not related to this particular study.

  • Patient consent for publication Not required.

  • Ethics approval The Helsinki Health Study has been ethically approved by the City of Helsinki health authorities, and the Department of Public Health, University of Helsinki, Finland, ethical committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data cannot be made publicly available due to strict data protection laws, but access to data can be applied from the Helsinki Health Study group, following current data sharing policies.