老化社會的工作永續性與職場健康不平等 :台灣工作者調查

Work Sustainability and Occupational Health Inequalities in an Aging Society: National Surveys of Working People of Taiwan

李宜靜(Yi-Jing Li)

指導教授 ： 鄭雅文

國立臺灣大學/公共衛生學院/健康政策與管理研究所/碩士(2019年)

https://doi.org/10.6342/NTU201903011

摘要

背景：台灣因新生人口數降低與人口老化，勞動人口下降，為了維持勞動人口平衡，讓中高齡工作者續留於職場，需重視工作永續性，亦即工作者願意且能夠工作至退休年齡。中高齡工作者因身體和心理適能下降，罹病的風險也增加，良好的工作環境對中高齡工作者相當重要，但不同的社會經濟階層和工作環境，會對中高齡工作者的健康產生不同影響，造成工作者的職場健康不平等。國內對工作永續性的狀況，與職場社會心理危害的相關性，以及職場上工作者的社會階層狀況，與職場社會心理特質和健康狀況的相關性分析仍相當不足。
研究目的：本研究有兩個研究目的。首先，了解工作永續性在不同社會人口與產業的分佈，並分析工作永續性與職場社會心理特質之相關性，第二，比較中高齡和非中高齡工作者在社會人口的分布，以及職場因素與健康狀況的社會階層分布，再比較中高齡與非中高齡工作者職場因素、不同社經階層與健康狀況相關性的差異。
方法：使用2010年及2016年台灣「工作環境安全衛生狀況認知調查」，2010年選擇25至55歲，11,209位男性工作者和8,189位女性工作者；2016年選擇25至65歲，8,419位男性工作者和6,454位女性工作者。職場因素包含工作時段與職場社會心理變項，職場社會心理變項參考中文版工作特質表，包含工作控制、工作心理負荷、工作體力負荷與工作保障，工作永續性為詢問受測者「預期60歲時的身心狀態，是否還可以勝任現在這份工作」，社會經濟階層指標使用工作者每個月的薪資收入，健康狀況指標，包含自評健康狀況、心理健康、肌肉骨骼不適與職業傷病。
研究結果：研究結果一：14.2%的男性與17.1%的女性工作者預期自己在60歲時無法或不願意從事現有工作；依產業與性別分析，可發現男性工作者工作永續性最低的產業為電子業，其次為營造業，女性工作者工作永續性最低的產業為醫療保健服務業，其次為電子業及教育服務業。羅吉斯迴歸分析顯示，在男女性工作者中，工作心理負荷高、有體力負荷與缺乏工作保障，是預期60歲時無法勝任現有工作的預測因子。
研究結果二：中高齡相較非中高齡工作者，薪資層級在最高和最低的比例較高；職場因素方面，中高齡相較非中高齡工作者，工作心理負荷低、工作家庭衝突低、契約關係為非長期、給薪方式為非固定薪資與每週工時小於40小時比例皆較高；健康方面，中高齡相較非中高齡工作者，男女性自評健康不佳、男性心理健康不佳、女性肌肉骨骼不適與男性有職業傷病的比例皆較高。在羅吉斯迴歸分析中，薪資階層低是健康狀況指標的預測因子；中高齡工作者原先薪資收入與各項健康狀況指標有相關，加入職場因素後變不顯著，非中高齡加入職場因素後薪資收入仍有顯著。
結論：本研究指出工作缺乏永續的高風險職業族群，以及中高齡與非中高齡工作者在薪資收入、職場因素與健康狀況的差異。在未來人口老化日漸嚴重的社會中，應制訂預防職場社會心理危害的預防策略，提升工作的永續性與改善中高齡工作者的健康不平等，使工作者可以續留職場，維持勞動力人口的平衡。

關鍵字

工作永續性 ； 職場社會心理因素 ； 就業 ； 社會經濟階層 ； 健康不平等

並列摘要

Background: Due to the low birth rates and the aging of the population, the working population begins to decline in Taiwan. In order to maintain the balance of working population and led older workers to prolong their working life, work sustainability which concerns workers’ intention to stay at the current job until retirement age should be valued. Especially, because older workers have higher health risk than young workers, workplace conditions are more important to older workers’ health. Furthermore, workers in lower socioeconomic status are more likely to have poor working conditions, resulting in health inequalities. However, few studied have been conducted on these issues in Taiwan.
Objectives: There were two objectives in this study. First, we studied the prevalence of work sustainability by social demographics and industry and examined its associations with psychosocial work factors. Secondly, we analyzed the differences between older workers and non-older worker in social demographics, working conditions and health status across socioeconomic status. Also examined were the associations of working conditions, socioeconomic status, and health status, stratified by age groups.
Methods: Study subjects were participants of a national survey conducted in 2010 and 2016, consisting of 11,209 male and 8,189 female workers aged between 25 to 55 years old in 2010; 8,419 male and 6,454 female workers aged between 25 to 65 years old in 2016. Psychosocial work factors were assessed by the Chinese version of Job Content Questionnaire (C-JCQ), which include job control, psychological job demands, physical job demands and job security. Work sustainability was assessed by a single question: “Thinking of your health status, would you expect yourself to stay at the current job at the age of 60 years old?”. Socioeconomic status was measured by income. Health status included self-rated health, mental health, musculoskeletal disorders and occupational injuries.
Results: Research 1: Descriptive analyses showed that 14.2% and 17.1% of male and female workers did not intend to stay the current job at the age of 60 years old. Lack of intention was more prevalent in workers in certain industrial sectors including electronics manufacturing industries for both genders and health care industry for female workers. Multivariate logistic regression models indicated that lack of intention to stay was associated with nonstandard work shift, higher psychosocial demands, physically demanding work, lower job control and higher job insecurity.
Research 2: It was found older worker had a higher proportion of the highest and lowest income levels than non-older workers. Lower psychological job demands, lower job-family conflict, non-fixed term in the employment contract, non-fixed salary in pay system and work hours per week< 40hours were more prevalent among older workers. Poorer self-rated health in both gender, poorer mental health in men, higher musculoskeletal disorders in women and higher occupational injuries in men were more prevalent among older workers. Multivariate logistic regression models indicated that income was associated with health status, but it became non-significant when working conditions were added in older workers but still significant in non-older workers.
Conclusion: Findings of this study highlight the high risk groups of low work sustainability and indicated that there were income-related differences in working conditions and health status in older workers and non-older workers. While the population is aging quickly, it is necessary to design preventive strategies to prevent psychosocial work factors. Through improving work sustainability and reducing health inequalities in older workers, we hope to increase workers’ working life and maintain the balance between work and health.

並列關鍵字

work sustainability ； psychosocial work factors ； employment ； socioeconomic status ； health inequalities

參考文獻

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