professor, md, phd. matti ylikoski reykjavik 9.11. 2009
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Health Promotion and Maintenance of Workability - National and Local Opportunities in Ensuring Employability of Aging Workforce -. Professor, MD, PhD. Matti Ylikoski Reykjavik 9.11. 2009. Contents of the presentation. - PowerPoint PPT PresentationTRANSCRIPT
Health Promotion and Maintenance of Workability
- National and Local Opportunities in Ensuring Employability of Aging Workforce -
Professor, MD, PhD. Matti YlikoskiReykjavik 9.11. 2009
Prof. M Ylikoski, FIOH / 24.04.23 2
Contents of the presentation
1. The "why" of a National Strategy for "Promotion and Maintenance of Work Ability (PMWA)" – in Finland
2. The PMWA model, definitions and framework3. PMWA in practice4. Summary and conclusions
Prof. M Ylikoski, FIOH / 24.04.23 3
1. The "why" of a National Strategy for "Promotion and Maintenance of Work Ability (PMWA)" – in Finland
Prof. M Ylikoski, FIOH / 24.04.23 4
Population changes in Finland 1749 – 2008
Birth – rate Death- r Immigrants Emigration
Future demographic challenge was recognised
Prof. M Ylikoski, FIOH / 24.04.23 5
0
200000
400000
600000
800000
1000000
1200000
1400000
1865 1878 1891 1904 1917 1930 1943 1956 1969 1982 1995 2008
15-29
45-59
Finnish population by age groups 1865 – 2008(Central Statistical Bureau, Fi)
Future shortage of young workers became critical
Prof. M Ylikoski, FIOH / 24.04.23 6
1865 1890 1915 1940 1965 1990 2015 20400
20
40
60
80Ikä
Alle 15-v.Yli 65-v.
Väestöllinen huoltosuhde 1865-2050
Lapsia ja eläkeikäisiä 100 työikäistä kohti1912: 70,8 2026: 70,7
1912: 61 lasta, 10 eläkeikäistä2008: 25 lasta, 25 eläkeikäistä2026: 28 lasta, 43 eläkeikäistä
2008: 50,3
Dependency Rate 1865 – 2050Children and retired per 100 people at working age
61 children; 10 retired25 childern; 26 retired28 children; 43 retired
Age> 65 y< 15 y
In 2008 in whole Finnish history the number of 65 years or older was higher than the number of those under 15 years old.
Prof. M Ylikoski, FIOH / 24.04.23 7
Important reasons for staying at work until statutory old-age retirement
(Statistics Finland 2006)
445353
5660616264
6770
0 10 20 30 40 50 60 70 80 90 100
Sabbatical
Better health care
More flexible working times
More opportunities for education
Higher salary
Improvements in work environment
Better leadership
Better rehabilitation opportunities
More challenges in work content
Decrease in workload and haste
%
Prof. M Ylikoski, FIOH / 24.04.23 8
> 20 years follow–up research for the why of the strategy - a cohort of 7000 municipal employees since 1981 -
(Tuomi ym. 2005; Ilmarinen 1996)
1. Workplace supports work ability and health (and the business), if:
– well organised, open communication and collaboration– opportunities to develop and influence, – managing over- and underloading – managing conflicts and insecurity at work
2. Mismatch between man and work varies with age and work3. Work ability varies widely between branches and trades
– work should be adjusted with flexibility through the life course– new abilities are needed for info-jobs and new technologies– retired, temporary hindered and unemployed have work ability still– return to work (sick pay; rehabilitation) needs support
4. Problems to appear:– economic depression with restructurings– agriculture and forestry, pulp and paper- and metal industries,
transportation, construction, social services– vulnerable groups: women, handicapped, youngsters, unemployed
aso.
Work ability was seen as the most important asset of employees
in work life, where: health and functional capacity are basic
explanatory variables which influence to – and depend on
- other individual and work related factors,
such as workplace as an organisation and community.
A systemic approach was needed !
Prof. M Ylikoski, FIOH / 24.04.23 9
Workplace health promotion as a model to maintain and promote work ability
- a systemic approach -
• Health promotion are empowering activities which, aim:– to increase the opportunities and prerequisites of people in
taking care of the health of them, their environment, in their community, and with the support of its social resources (WHO: Ottawa Charter 1986)
• Workplace is ONE of the settings and "social arenas", which offer special opportunities to promote workers´ health an work ability:
– as a community and a decision making system with resources for health and thus, for adjusting work for workers health, and
– as an environment with particular exposures and thus, duties concerning to manage and combat against hazardous loadings.
Prof. M Ylikoski, FIOH / 24.04.23 10
(Work) Life
Individual witha handicap
Medical invalidity
Individual with limitedabilities in regard of job demands
JobIndividual
Disability
Individual in the work life context and "system"
Organisation
Bio – Psycho – Social"residual" work ability
(Work) Life
From "handicap" orientation - via balance model - towards a multifactorial approach
Prof. M Ylikoski, FIOH / 24.04.23 11
Widening of the "Well-being at Work" concept (Hämäläinen 2008, Hanson 2007, Ylikoski ym. 2006, Kickbusch 2004, Whitelaw ym. 2001)
1. From pathogenic approach towards "salutogenic" view• what is dangerous to health what is good for health and well-
being– health as a resource in meeting life (conditions/environment)
2. From prevention towards promotion• risk factors health and work ability determinants• protect and avoid strengthen, support• reactive predictive (proactive)
– unemployment research coping with transitions at work life 3. From objects for expert actions towards participation of the
empowered people• individual lifestyle population & organisational (setting)
partnership strategies with empowered actors• general models and Good Practices locally tailored solutions• specialized campaigns continuous strategic integration and
processes with committed actors4. (Re)integration of well-being and productivity
Prof. M Ylikoski, FIOH / 24.04.23 12
2. The PMWA model, definitions and framework
Prof. M Ylikoski, FIOH / 24.04.23 13
Work, functional capacity and age are linked- and there is lot to do -
(Ilmarinen 1999)
Age
Job demands
Functional capacity & competence
%
Reserve
Decrease job demands
PROBLEM
SOLUTIONS
Promote and maintain work abilityReserve
Prof. M Ylikoski, FIOH / 24.04.23 14
PMWA: Rationale
• PMWA operations were based on:– knowledge of aging,– physiological, psychosocial and health changes needing
special emphasis due to aging of the work force and– knowledge for adjustment the work conditions according to the
individual at his/her situation.• However, recently the whole life course and work career are
considered as a challenge for the PMWA activities– qualifications needed at work are changing continuously– life course transitions challenge coping aptitudes regularly– organisational changes evoke individual support and
adjustments
Prof. M Ylikoski, FIOH / 24.04.23 15
Basic training
Vocationaltraining
Published 2006, disseminating
Published 2002country wide
Countrywide since 1997
TowardsWork life
From Schoolto Work
40+ workers
- transfer to decent job
re-employment
Pilot,to be published2009
To Job
Unemployed andkicked out
- promotionof activelearning career
Prevention of mental depression
-promotion of career-prevention of burn out
Successful Senior
Supporting career through the whole life course(Vuori et al. 2007)
Prof. M Ylikoski, FIOH / 24.04.23 16
Definition of the PMWA
• Workplace activities aiming at promoting and maintaining the ability to work
– include all measures,– that the employer and the employees as well as – the co-operative organizations at the workplace take in a united
effort– to support the ability to work and to enhance the functional
capacities of all persons active in working life– throughout their working careers
Two-Partite Consensus with recommendation 1990 Obligatory (employers duty) legislation 2001
Prof. M Ylikoski, FIOH / 24.04.23 17
3. PMWA in practice
Prof. M Ylikoski, FIOH / 24.04.23 18
PMWA
activitiesWork and work environment:
Work conditionsJob content and demands
Work community and organizationCommunity and organizationManagement and leadership
ParticipationOrganizational learning
Individual:Health and functional capacity
Subjective:Values
Attitudes and motivationCompetence
Professional and social
Target areas and their "weight" in the PMWA measures
(Ilmarinen 2006)
0 %5 %
10 %15 %20 %25 %30 %35 %40 %
Effect on work ability
healthcompetencevaluesworkcommunity
Family
Society
Prof. M Ylikoski, FIOH / 24.04.23 19
PMWA
activitiesWork and work environment
Work community and organization•empowering self – esteem health
•participation commitment achievements more concrete•co – construction organizational learning social capital
Individual
Values and competence
The organizational development axis in the PMWA "four flies with one hit"
- how to act in practice ? -
Prof. M Ylikoski, FIOH / 24.04.23 20
From practical experiences, research and corporative collaboration towards legislation,
wide programmes and good practices
Practical experiences • Experts (OS&H)• Workers, managers, HR
Social partners• Policies • Negotiations
Research• Long-term cohort
• Surveys
Good Practices: Experts (OS&H)
Work places
Social partners• Agreements • Recommendations
Legislation
Nation wideProgrammes
• Ministries• Social partners
• Soc Sec Insur Co´s• Regional networks
•Companies• NGO´s
1980 - 1990 - 2001 – 2005 - 1995 -
Main activities in practice
• PMWA in companies nationwide
and obligated for employers (2001 -)
• "Work Ability Index" for assessment (1998 - )
• "Flexible retirement" – legislation (2005 -)
• "Age Management" – training (1999 -)
• "Transition coping" – model (1997 - )
Prof. M Ylikoski, FIOH / 24.04.23 21
PMWA measures carried out:Training and competence building
35
42
60
58
81
51
55
66
71
91
0 10 20 30 40 50 60 70 80 90 100
Training of planning skills
Training of team skills
Quality training
Training for the use equipment
Supporting competence building
%
Management (n = 882)Personnel (n = 812)
Prof. M Ylikoski, FIOH / 24.04.23 22
PMWA in operation: Improvements in team function and organization
31
35
36
49
46
52
53
60
54
54
62
69
47
40
51
63
75
79
67
80
75
75
80
82
0 10 20 30 40 50 60 70 80 90
Dimishing of hurrying and time-pressure
Increasing flexibility in working time
Strengthening the skills to control change and crisis
Improvements in organisation and division of work tasks
Improving the appreciation of personnel
Increase of feedback and support
Increase in independence and responsibilities in work
Development of leadership and supervisory skills
Improvement in communication
Clarification of the goals of work processes
Increase in cooperation and participation
Improvent in planning and quality control
%Management (n = 882)Personnel (n = 812)
Prof. M Ylikoski, FIOH / 24.04.23 23
Positive effects achieved
8 8
14 13
29
17
26
1310
7 85
26
1613
10
4
13 116
25
16 15
8
0
10
20
30
40
Nothing at all Less sicknessabsence
Well-being atwork improved
O rganisationalclimate
improved
%
Management 2001 (n = 882) Personnel 2001 (n = 813)O HS 2001 (n = 743)
Work environment improved
Motivation to work higher
Physical fitness increased
Cooperation improved
Prof. M Ylikoski, FIOH / 24.04.23 24
The benefits of PMWA is equivalent to it's costs (employers 1999 & 2005)
21
63
50
10
28
62
3 06
010203040506070
Very good Fairly good Fairly bad Very bad Can't say
%
(Work Ability Barometer 2005)
Prof. M Ylikoski, FIOH / 24.04.23 25
Expected effective retirement age for 50-year-oldsNordic countries in 1996–2007
Prof. M Ylikoski, FIOH / 24.04.23 26
Expected effective retirement age for 30-year-oldsNordic countries in 1996–2007
Prof. M Ylikoski, FIOH / 24.04.23 27
Expected effective retirement age for 30-year-oldsNordic countries 1996–2007, females
Prof. M Ylikoski, FIOH / 24.04.23 28
69,4
59,5
52,7 51,6 50,5
43,137,9
31,8 31,8 31,7 31,4
56,9
41,645,446,144,1
0
10
20
30
40
50
60
70
80
SE DK UK FI IE PT NL DE ES EL FR BE AT LU IT
Employment rates of the 55+ in the EU-15, 2005
Source: Employment in Europe 2006
Stockholm- target EU-15 average
Prof. M Ylikoski, FIOH / 24.04.23 29
Finland: Increase in the employment rate of ageing workers has been most prominent in the EU during the
latest 15 years (18 % - units !!)
Statistics Finland 2006
Employment rate
Age group
Prof. M Ylikoski, FIOH / 24.04.23 30
PMWA Activities in Finland- evaluative summary
• Amount of PMWA quite high with many positive effects• Versatile content of PMWA• High confidence to economical benefits:
– good cost and benefit ratio,– follow – up of the cost – efficiency has increased
• The role of OHS significant• SMEs need more support
Prof. M Ylikoski, FIOH / 24.04.23 31
Thank You for Your Attention !Thank You for Your Attention !
Prof. M Ylikoski, FIOH / 24.04.23 32
Further readings
• Ministry of Social Affairs and Health & Finnish Institute of Occupational Health (2004): Good occupational health practice. A guide for planning and follow - up of occupational health services. Ministry of Social Affairs and Health & Finnish Institute of Occupational Health. Helsinki. ISBN 951-802-566-5
• Ilmarinen J. Towards a Longer Worklife ! Ageing and the quality of worklife in the European Union. Finnish Institute of Occupational Health, Helsinki 2005.
• ILO: Tackling Global Crisis. Recovery through decent work policies. RepI(A) 2009• Vahtera J, Kivimäki M, Pentti J, Linna A, Virtanen M, Virtanen P, Ferrie JE.
Organisational downsizing, sickness absence and mortality: the 10-Town prospective cohort study. British Medical Journal 2004; 328:555-557
• Tuomi K, Ilmarinen J, Martikainen R et al.: Aging, work, life-style and work ability among Finnish municipal workers in 1981-1992. Scand J Work Environ Health 23 (1997): suppl 1, 58-65.
• Vuori, J., Koivisto, P., Mutanen, P., Jokisaari, M., & Salmela-Aro, K. (2008). Towards Working Life: Effects of an intervention on mental health and transition to post-basic education. Journal of Vocational Behavior, 72, 67-80.
• Ylikoski M, et al. Health in the World of Work: workplace health promotion as a tool for improving and extending work life. Helsinki, Finnish Institute of Occupational Health, 2006. (Reports of the Ministry of Social Affairs and Health 2006:62)
• Ylikoski M, Rantanen, J: The development of modern work organisations: a challenge to occupational safety and health. In Wirtschaftverlag NW (Ed): The future of working conditions: Tb / Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, 102: 289-297, Bremerhaven, 2000.