- Develop elder friendly & safe workplace environments, pay satisfactory wages, & facilitate adequate social interaction
The majority of elderly workers in Sri Lanka are having a poor quality of work life (not satisfactory) and policies, practices and interventions aimed at developing elder-friendly and safe workplace environments, the payment of satisfactory wages, and the provision of adequate social interaction including for the development of friendships could enable them to gain work-related socio-economic benefits whilst accommodating their physical and psychosocial limitations.
These findings and recommendations were made in an original research article on the ‘Quality of work life and factors associated with it among elderly workers in Sri Lanka (low middle-income country)’ which was authored by N. Gunathilaka (attached to the Health Ministry's National Sexually Transmitted Diseases and Acquired Immunodeficiency Syndrome Control Programme), and M.C. Weerasinghe and D. Samaranayake (both attached to the Colombo University's Medical Faculty's Community Medicine Department) and published in the Journal of the College of Community Physicians of Sri Lanka's 30th Volume's Third Issue, last month.
Quality of work life can be defined as ‘the employee’s satisfaction with personal and working related needs through participating in the work while achieving the goals of the organisation’ (D.R. Swamy, T.S. Nanjundeswaraswamy and S. Rashmi's ‘Quality of work life: Scale development and validation’). The most commonly identified dimensions of it are broadly categorised into health related aspects, the work environment, the organisational culture, job satisfaction, job security, the autonomy of work, the availability of resources and the work-life balance (B. May, R. Lau and S.K. Johnson's ‘A longitudinal study of quality of work life and business performance’, M.J. Sirgy, D. Efraty, P. Siegel and D-J. Lee's ‘A new measure of the quality of work life based on the need satisfaction and spillover theories’ and an Indian study [V. Mehrotra and V. Khandelwal's Association of demographic variables {gender and salary} on the quality of work life of teaching employees in private technical institutions in the Bareilly Region’]).
A good quality of work life is an indicator of a healthy and safe workplace, which determines the health and wellbeing of employees and facilitates the management of the workers’ personal lives and reduces fatigability (S. Kanten and O. Sadullah's ‘Empirical research on the relationship quality of work life and work engagement’), while a low quality of work life results in negative health outcomes (a Catalonian study [S.L. Dolan, S. García, C. Cabezas and S.S. Tzafrir's ‘Predictors of 'quality of work' and 'poor health' among primary healthcare personnel in Catalonia’]).
According to the International Labour Organisation's projections in 2015, the participation of elderly workers in the workforce will exceed 18% by 2030. The projections of the Organisation for Economic Cooperation and Development (OECD) show that the ratio of elders to the working age people will rise from one in four in 2015 to one in two in 2050, making ageing a major social and economic challenge with an inevitable workforce shrinkage (OECD Council Recommendation on Ageing and Employment). In Sri Lanka, one fourth of the elderly population presently contributes to the labour force (W.I. De Silva and D.N.P. Fernando's ‘Changing causes and consequences of labour force participation trends among the elderly in Sri Lanka’) and the minimum retirement age had been announced as 65 years (the Ministry of Public Administration's ‘Extension of the compulsory retirement of public officers up to 65 years’ Circular 02/2022).
Despite the increased likelihood of having disabilities and age related physical impairments, elderly workers are considered valuable to an organisation because of their specialised knowledge, leadership skills and experiences. A reasonable percentage of skilled elderly workers are engaged in ‘bridging employment’ (participation in the labour force between retirement from full-time work to complete workforce withdrawal – M.E. Beier and R. Kanfer's ‘Work performance and the older worker’).
Efforts to optimise the working conditions and to remove barriers related to their age related disabilities are crucial to support the productivity of the elderly workforce. The World Health Organisation’s (WHO) recommendations on the ‘Active ageing’ Policy framework highlight the importance of creating age friendly, safe environments for elders. Though there are very few workplace based health promotion activities tailored for elderly workers, the quality of these interventions is very poor (A. Poscia, U. Moscato, D.I.L. Milia, S. Milovanovic, J. Stojanovic, A. Borghini, A. Collamati, W. Ricciardi and N. Magnavita's ‘Workplace health promotion for older workers: A systematic literature review’).
Methods
Gunathilaka et al. conducted a community (low-middle-income setting) based, cross-sectional study in the Gampaha District in the Western Province. The study population consisted of elderly workers who lived in the District for more than six months. An elderly worker was defined as ‘a person aged 60 years or above, who had been working for the last six months, at least for 20 hours per week’. The worker may belong to any skill level and can be a paid regular employee or a self-employed person who works for a salary in cash or in goods. Casual workers and seasonal workers were excluded. Severely ill workers who were not fit to engage in the study were excluded.
The sample was recruited using multi-stage cluster sampling, in which a Grama Niladhari Division (GND) was considered as a cluster, with the cluster size decided as 10 participants. At the first stage, seven Divisional Secretariat Divisions were selected, from which, in the second stage, 85 GNDs were selected proportionate to the population size. A total of 10 elderly workers were selected from each GND using random sampling at the third stage.
Data collection was done during May-August, 2019. However, while an interviewer administered questionnaire was used, it could have caused the social desirability bias.
Results
Of the invited participants, 835 responded, giving a response rate of 98.6%. Their mean age was 66 years (standard deviation [SD] - 4.8 years). The majority was males (68.7%), belonging to skill level two (performance of tasks with machinery equipment, ordering and the storage of information) (70.1%), self-employed (43.6%) and as service workers and shop and market sales workers (39.5%). Almost 96% were employed before the age of 60 and 58.4% were continuing the same occupation.
The mean quality of work life score (based on socio-demographic factors and associated factors such as individual factors, health and health services related factors, psychological factors, social interaction related factors, religious factors and work related factors) was 119.42 (SD - 12.18) with the total score ranging from 68 to 150. With a cut-off mark of 126, the prevalence of an overall good quality of work life was 32.1%. The majority had good scores in the psychology, facility, safety, job content, supervisor and autonomy related domains. The domains, namely physical health (assessing age related disabilities like joint pains and non-communicable diseases), co-worker and flexibility (assessing the degree to which the work was adapted for an elderly person), had low scores.
Out of the 84 factors examined, 10 were significantly associated with a good quality of work life, with earning more than Rs. 30,000 per month, having properties for income generation, being employed before 60 years, having social interactions and having adequate social support showing positive significant associations with a good quality of work life and spending on one's own food, having arthritis (common conditions that cause pain, swelling, and limited movement, and means redness and swelling/inflammation of a joint, and which affects joints and connective tissues around the body), experiencing work related accidents and working to support the family showing significant negative associations with a good quality of work life. The factor with the largest effect size was that the job helps to have social interactions. The other associated factor was engaging in political activities.
Discussion
Among the study participants, only one-third reported having a good quality of work life. Most who remained in work after the age of 60 were male, low skilled workers, in private or informal employment or were self-employed. Elderly people generally lack employment opportunities in the formal sector and most of the time, settle for informal work that under-utilises their skills. This underemployment could be a reason for the low overall quality of work life. Similar to the overall quality of work life, the physical health domain was also rated low by a majority, which indicates that the elderly workers’ jobs do not cater well to their physical health related needs. However, the domains of psychology, safety and autonomy were rated highly by a majority. Also, the job content (which includes the work environment, work related responsibilities and job security) was rated as good, and this indicates that elderly workers perceive their job environments as safe and supportive, both physically and psychologically.
The study findings indicate that economic factors are associated positively as well as negatively with the quality of work life of the elderly workers. Higher levels of incomes either with the salaries or with other income generation methods were associated with a good quality of work life. Low income may affect a person’s ability to meet basic needs such as buying food, paying rent and paying the bills, and jobs that do not provide for the basic needs are likely to be rated poorly by the workers. Furthermore, according to the World Bank Annual Report 2008, 80% of the elderly live with their children in most developing countries. Most contribute to their family's economic status, and when they are compelled to do so, it can be a psychological burden to them. The study findings also prove that the workers who engage beyond their working age to support their families are more likely to settle for jobs with a poor quality of work life.
The current study shows that elderly workers being unable to rely on their children for food and having to earn for their food is a factor influencing the poor quality of work life. This may reflect that elderly workers feel negatively about having to work to earn their food and being compelled to engage in employment due to dire financial need.
The present study showed that the workers who were employed before the age of 60 years had a better quality of work life in their current jobs. A.M. Mosadeghrad's ‘Quality of working life: An antecedent to employee turnover intention’ explained this finding as a result of the longer work experience where the workers develop skills on communication and co-worker relationships. Furthermore, those who had been working before 60 years of age are more likely to be skilled workers who have the ability to secure better employment even after the retirement age.
Experiencing work-related injuries was associated with a poor quality of work life. Accidents being an undesired outcome of any occupation, a low quality of work life is expected with work related injuries. M. Leiter and C. Maslach's ‘Burn out and workplace injuries: A longitudinal analysis’ showed that safe and healthy work related conditions have a high impact on the quality of work life while the pain and disability caused by occupational accidents can cause psychological stress to the worker as mentioned in L.A. Fraade-Blanar, J.M. Sears, K.C.G. Chan, H.J. Thompson, P.K. Crane and B.E. Ebel's ‘Relating older workers' injuries to the mismatch between the physical ability and job related demands’. Also, medical expenses, getting low wages due to reduced productivity and being absent from work are the other negative consequences of occupational injuries. An American study (T.D. Smith and D.M. DeJoy's ‘Occupational injury in America: An analysis of risk factors using data from the General Social Survey") reported a 32% reduction in organisational effectiveness when work related injuries are frequently reported.
When the workers are having joint problems, their work related ability reduces, leading to less productivity and a low quality of work life. However, having arthritis was assessed as a self-reported illness. Many of the elders may have musculoskeletal disorders, which are not arthritis and an undiagnosed arthritis condition may be present among elderly workers. Therefore, the significant association between arthritis and the quality of work life needs to be interpreted cautiously, Gunathilaka et al. explained.
A. Seyfzadeh, M. Haghighatian and A. Mohajerani's ‘Social isolation in the elderly: The neglected issue’ has shown that elders experience much social isolation at present and employ different strategies to connect with society. Work creates large social networks that reduce social isolation in the elderly, according to an American study (E.Y. Cornwell and L.J. Waite's ‘Measuring social isolation among older adults using multiple indicators from the National Social Life, Health, and Ageing Project study’). Employment helps to improve social interaction and thereby a good quality of work life. Further, having adequate social support has a strong association with a good quality of work life.
Therefore, evidence based ‘elder-friendly work’ policies and practices should be incorporated into related interventions.