Association of short poor work ability measure with increased mortality risk: A prospective multicohort study

Abstract

Objectives To examine whether a single-item measure of self-rated work ability predicts all-cause mortality in three large population-based samples collected in 1978-1980, 2000 and 2017. Setting A representative sample of the population of Finland. Participants The study population comprised 17 178 participants aged 18 to 65 from the population-based Mini-Finland, Health 2000 and FinHealth 2017 cohort studies, pooled together. In all cohorts, self-rated work ability was assessed at baseline (1978-80, 2000-2001 and 2017) using three response alternatives: completely fit (good work ability), partially disabled (limited work ability) and completely disabled (poor work ability) for work. Primary and secondary outcome measures All-cause mortality from national registers. Cox proportional hazards models were adjusted for socioeconomic characteristics, lifestyle factors, self-rated health and mental health problems. Results Of the participants, 2219 (13%) were classified as having limited and 991 (5.8%) poor work ability and 246 individuals died during the 4 year follow-up. The age- and sex-adjusted HR for mortality risk was 7.20 (95% CI 5.15 to 10.08) for participants with poor vs good work ability and 3.22 (95% CI 2.30 to 4.43) for participants with limited vs good work ability. The excess risk associated with poor work ability was seen in both genders, all age groups, across different educational levels, self-rated health levels and in those with and without mental health problems. The associations were robust to further adjustment for education, health behaviours, self-rated health and mental health problems. In the multivariable analyses, the HR for mortality among those with poor vs good work ability was 5.75 (95% CI 3.59 to 9.20). Conclusions One-item poor self-rated work ability -measure is a strong predictor of increased risk of all-cause mortality and may be a useful survey-measure in predicting severe health outcomes in community-based surveys.