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How does job dissatisfaction interact with self-rated health in determining the risk of health-related job loss? Prospective findings from the Health and Employment After Fifty (HEAF) study
  1. Stefania D'Angelo1,
  2. Holly Syddall1,
  3. Georgia Ntani1,2,
  4. E Clare Harris1,2,
  5. Cathy Linaker1,2,
  6. Cyrus Cooper1,
  7. Martin Stevens1,
  8. Karen Walker-Bone1,2
  1. 1 MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
  2. 2 MRC Versus Arthritis Centre for Musculoskeletal Health and Work, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
  1. Correspondence to Stefania D'Angelo, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, UK; sd{at}


Objectives Health and job satisfaction are key independent determinants of ability to work to older ages. We investigated the interaction of these two important factors on health-related job loss (HRJL) over 2 years of follow-up comparing male and female older workers.

Methods A population sample of adults aged 50–64 years, recruited from 24 English general practices in the Health and Employment After Fifty (HEAF) study, completed questionnaires at baseline with follow-ups at 12 and 24 months. Multiple-record Cox proportional hazards models were performed to explore the main effects of, and potential interactions between, job satisfaction and self-rated health (SRH) as predictors of time to first HRJL.

Results Of the initial 8134 participants, 5143 were ever in work in the study period. Among men, 5.7% and 14.3% reported job dissatisfaction (those in good and poor SRH, respectively), while among women these percentages were 4.6 and 12.9. HRJL was reported by 106 men and 176 women. Men in good health dissatisfied with their job had a sixfold (HR=6.4; 95% CI 3.3 to 12.4) increased risk of HRJL compared with men satisfied with their job (significant multiplicative interaction). Women dissatisfied with their job were more likely to have an HRJL within 2 years of follow-up irrespective of their SRH.

Conclusions SRH and job dissatisfaction have important individual effects on the risk of stopping work for health among older workers. These findings point to the importance of job satisfaction in reducing health-related exit from paid work among older workers.

  • fitness for work
  • ageing
  • musculoskeletal
  • retired

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  • Contributors SD and KWB identified the study questions. KWB, CHL, ECH and MJS supervised data collection. SD, HES and GN planned the analyses and SD conducted the analyses. SD wrote the first draft of the paper. All authors contributed to the writing of subsequent and final drafts of the manuscript.

  • Funding The HEAF study is funded by the Medical Research Council programme grant (MC_UU_12011/5), and by grant awards from Versus Arthritis (formerly Arthritis Research UK) (22090); and the Economic and Social Research Council and Medical Research Council jointly (ES/L002663/1).

  • Competing interests CC has received consultancy and honoraria from Alliance for Better Bone Health, Amgen, Eli Lilly, GSK, Medtronic, Merck, Novartis, Pfizer, Roche, Servier, Takeda and UCB.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was obtained from the National Health Service Research Ethics Committee North West-Liverpool East (Reference 12/NW/0500) and all participants gave written informed consent.

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

  • Data availability statement Data are available on reasonable request. These are deidentified participant data and are available on request from the 'Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work'. The Centre Manager and Administrator are ECH ( and Sue Curtis (, respectively.