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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.
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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 • The "why" of a National Strategy for "Promotion and Maintenance of Work Ability (PMWA)" – in Finland • The PMWA model, definitions and framework • PMWA in practice • Summary and conclusions Prof. M Ylikoski, FIOH / 24.9.2014
The "why" of a National Strategy for "Promotion and Maintenance of Work Ability (PMWA)" – in Finland Prof. M Ylikoski, FIOH / 24.9.2014
Population changes in Finland 1749 – 2008 Future demographic challenge was recognised Emigration Death- r Immigrants Birth – rate Prof. M Ylikoski, FIOH / 24.9.2014
Finnish population by age groups 1865 – 2008 (Central Statistical Bureau, Fi) Future shortage of young workers became critical Prof. M Ylikoski, FIOH / 24.9.2014
Dependency Rate 1865 – 2050 Children and retired per 100 people at working age 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. 61 children; 10 retired 25 childern; 26 retired 28 children; 43 retired Prof. M Ylikoski, FIOH / 24.9.2014
Important reasons for staying at work until statutory old-age retirement(Statistics Finland 2006) Prof. M Ylikoski, FIOH / 24.9.2014
> 20 years follow–up research for the why of the strategy- a cohort of 7000 municipal employees since 1981 - (Tuomi ym. 2005; Ilmarinen 1996) • 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 • Mismatch between man and work varies with age and work • 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 • 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 / 24.9.2014
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 / 24.9.2014
From "handicap" orientation - via balance model - towards a multifactorial approach Individual with limited abilities in regard of job demands Individual in the work life context and "system" Individual with a handicap (Work) Life Organisation Job Individual (Work) Life Bio – Psycho – Social "residual" work ability Disability Medical invalidity Prof. M Ylikoski, FIOH / 24.9.2014
Widening of the "Well-being at Work" concept (Hämäläinen 2008, Hanson 2007, Ylikoski ym. 2006, Kickbusch 2004, Whitelaw ym. 2001) • 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) • 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 • 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 actors • (Re)integration of well-being and productivity Prof. M Ylikoski, FIOH / 24.9.2014
2. The PMWA model, definitions and framework Prof. M Ylikoski, FIOH / 24.9.2014
Work, functional capacity and age are linked- and there is lot to do -(Ilmarinen 1999) % Functional capacity & competence PROBLEM Promote and maintain work ability Reserve Reserve Job demands Decrease job demands Age SOLUTIONS Prof. M Ylikoski, FIOH / 24.9.2014
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 / 24.9.2014
- transfer to decent job Supporting career through the whole life course (Vuori et al. 2007) 40+ workers / Unemployed and kicked out Successful Senior Vocational training To Job • promotion of career • prevention of burn out re-employment From School to Work Basic training Towards Work life Pilot, to be published 2009 Prevention of mental depression - promotion Country wide since 1997 of active learning career Published 2002 country wide Published 2006, disseminating Prof. M Ylikoski, FIOH / 24.9.2014
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 / 24.9.2014
3. PMWA in practice Prof. M Ylikoski, FIOH / 24.9.2014
Target areas and their "weight" in the PMWA measures (Ilmarinen 2006) Individual: Health and functional capacity Society Family PMWA activities Work and work environment: Work conditions Job content and demands Subjective: Values Attitudes and motivation Competence Professional and social Work community and organization Community and organization Management and leadership Participation Organizational learning Prof. M Ylikoski, FIOH / 24.9.2014
The organizational development axis in the PMWA "four flies with one hit" - how to act in practice ? - Individual PMWA activities Values and competence Work and work environment • Work community and organization • empowering self – esteem health • participation commitment achievements more concrete • co – construction organizational learning social capital Prof. M Ylikoski, FIOH / 24.9.2014
From practical experiences, research and corporative collaboration towards legislation, wide programmes and good practices 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 - ) Practical experiences • Experts (OS&H) • Workers, managers, HR Good Practices: Experts (OS&H) Work places Nation wide Programmes • Ministries • Social partners • Soc Sec Insur Co´s • Regional networks • Companies • NGO´s Research • Long-term cohort • Surveys Legislation Social partners • Policies • Negotiations Social partners • Agreements • Recommendations 1995 - 1980 - 1990 - 2001 – 2005 - Prof. M Ylikoski, FIOH / 24.9.2014
PMWA measures carried out:Training and competence building Prof. M Ylikoski, FIOH / 24.9.2014
PMWA in operation: Improvements in team function and organization Prof. M Ylikoski, FIOH / 24.9.2014
Positive effects achieved Cooperation improved Work environment improved Physical fitness increased Motivation to work higher Prof. M Ylikoski, FIOH / 24.9.2014
The benefits of PMWA is equivalent to it's costs (employers 1999 & 2005) % 70 63 62 60 50 40 28 30 21 20 10 10 6 5 3 0 0 0 Very good Fairly good Fairly bad Very bad Can't say (Work Ability Barometer 2005) Prof. M Ylikoski, FIOH / 24.9.2014
Expected effective retirement age for 50-year-olds Nordic countries in 1996–2007 Prof. M Ylikoski, FIOH / 24.9.2014
Expected effective retirement age for 30-year-olds Nordic countries in 1996–2007 Prof. M Ylikoski, FIOH / 24.9.2014
Expected effective retirement age for 30-year-olds Nordic countries 1996–2007, females Prof. M Ylikoski, FIOH / 24.9.2014
Employment rates of the 55+ in the EU-15, 2005 Stockholm- target EU-15 average Source: Employment in Europe 2006 Prof. M Ylikoski, FIOH / 24.9.2014
Finland: Increase in the employment rate of ageing workers has been most prominent in the EU during the latest 15 years (18 % - units !!) Employment rate Age group Statistics Finland 2006 Prof. M Ylikoski, FIOH / 24.9.2014
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 / 24.9.2014
Thank You for Your Attention ! Prof. M Ylikoski, FIOH / 24.9.2014
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. Prof. M Ylikoski, FIOH / 24.9.2014