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Further decoding the mystery of American pain: The importance of work.

ABSTRACT: A recent paper showed that, whereas we expect pain to rise with age due to accumulated injury, physical wear and tear, and disease, the elderly in America report less pain than those in midlife. Further exploration revealed this pattern was confined to the less educated. The authors called this the 'mystery of American pain' since pain appears to rise with age in other countries irrespective of education. Revisiting this issue with the same cross-sectional data we show that what matters in explaining pain through to age 65 is whether one is working or not. The incidence of pain across the life-course is nearly identical for workers in America and elsewhere, but it is greater for non-working Americans than it is for non-workers elsewhere. As in other countries, pain is hump-shaped in age among those Americans out of work but rises a little over the life-course for those in work. Furthermore, these patterns are apparent within educational groups. We show that, if one ascribes age-specific employment rates from other OECD countries to Americans, the age profile of pain in the United States is more similar to that found elsewhere in the OECD. This is because employment rates are lower in the United States than elsewhere between ages 30 and 60: the simulation reduces the pain contribution of these non-workers to overall pain in America, so it looks somewhat similar to pain elsewhere. We conclude that what matters in explaining pain over the life-course is whether one is working or not and once that is accounted for, the patterns are consistent across the United States and the rest of the OECD.

SUBMITTER: Blanchflower DG

PROVIDER: S-EPMC8758074 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundWork engagement is crucial for quality care at the primary healthcare level. This is especially true during the Covid-19 pandemic, as it has effects on the community from both a health and economic point of view. For example, inadequate work engagement can lead to fewer referrals to the secondary healthcare level. This study aims to examine the work engagement level in a public healthcare organisation at the primary healthcare level to further explore the role of work environment characteristics. The study addresses a research gap in the field of primary healthcare and emphasises the importance of managing the factors promoting work engagement. The future of healthcare will be strongly shaped by population ageing and Covid-19 disruption, which have created unpredictable and unfavourable working situations.MethodA descriptive, cross-sectional, correlational design was used including the Utrecht Work Engagement Scale with a non-probabilistic availability sample of 630 employees of the Community Health Centre Ljubljana, Slovenia, in 2018. The role of the work environment was observed by applying the job resources concept adapted to the context of the observed organisation.ResultsWork engagement in the observed organisation is higher compared to previous research. The research confirmed that job resources play an important role in employees' work engagement. The high level of work engagement of the home care nursing employees coupled with the significant proportions of unengaged in the management of the organization also caught our attention. This difference highlights the importance of the leadership style, career choices and employment process that exist in an institution.ConclusionThe study has important implications for healthcare management at the primary level for unlocking the work engagement by 'managing' the factors stimulating work engagement. The hidden potential is especially large in so called 'soft areas', such as leadership style, communication and organisational climate, which are also less expensive to manage than other aspects of the work environment.

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Further decoding the mystery of American pain: The importance of work.

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