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INTRODUCTION
PARTICIPATION OF PEOPLE AGED 45–74 YEARS IN THE LABOUR FORCE
MATURE AGE WORKERS WITH NATIONAL HEALTH PRIORITY AREA CONDITIONS
SELF-ASSESSED HEALTH STATUS OF MATURE AGE WORKERS WITH NHPA CONDITIONS
LIFESTYLE RISK FACTORS OF PEOPLE AGED 45–74 YEARS WITH NHPA CONDITIONS
SOCIO-ECONOMIC CHARACTERISTICS OF MATURE AGE WORKERS WITH NHPA CONDITIONS
NHPA CONDITIONS AMONG MATURE AGE WORKERS BY INDUSTRY
NHPA CONDITIONS AMONG MATURE AGE WORKERS BY OCCUPATION
HOURS WORKED BY FULL-TIME MATURE AGE WORKERS
WORK-RELATED NHPA CHRONIC DISEASES
MANAGING NHPA CONDITIONS



INTRODUCTION
Ill health can impact on a person's quality of life and their ability to participate productively in the labour force. As people age, there is often an increase in the number of long-term conditions (footnote 1) they may have, with many conditions such as cardiovascular disease, diabetes and arthritis or osteoporosis particularly associated with older age groups. These diseases are three of eight conditions named as National Health Priority Areas (NHPAs) (footnote 2) – arthritis or osteoporosis and musculoskeletal conditions, asthma, cancer, cardiovascular disease, diabetes, injury, mental health and obesity - chosen because of their significant contribution to the burden of disease and injury in Australia.

In recent decades life expectancy has been increasing, and people are remaining in the labour force longer. Maintaining good health supports participation in the labour force and increased participation contributes to a stronger economy. As people approach retirement age, their health is one of the factors that may influence decisions about their participation in the labour force.

This snapshot compares the health characteristics of mature age workers (i.e. those aged 45–74 years) with people in the same age group who are not in the labour force (footnote 3), focusing in particular on NHPA conditions. This age group has been selected as the one which is most likely to contain people in the workforce who are considering the timing of their retirement.

DATA SOURCES
The majority of the information for this snapshot is drawn from the ABS 2004–05 National Health Survey (NHS), as well as other ABS collections. Unless otherwise stated, mature age workers are those aged 45–74 years.

INQUIRIES
For further information about these and related statistics, contact the National Information and Referral Service on 1300 135 070 or email client.services@abs.gov.au.

• In recent decades, Australia’s labour force participation rate (footnote 4) has been influenced by the changing age structure of the population, the increasing trend towards part-time work and higher participation by women. In the 20 years to March 2008, the participation rate of people aged 45 years and over increased from 40% to 50%, while the participation rate for those aged 15–44 years changed very little, from 78% to 80%. Almost half (49%) of people aged 45 years and over were employed and only 1% were unemployed (ABS 2008a). Because such a small proportion of people aged 45 years and over were unemployed, they have been excluded from the analyses in this snapshot.
• In general, women are more likely than men to be working part-time. As people move closer to retirement, they are increasingly likely to work part-time. The proportion of people aged 45 years and over who were in the labour force and working part-time increased by 36% over the 20 year period to March 2008, from 21% to 28%. In March 2008, 15% of men aged 45 years and over were employed part-time compared with 46% of working women in this age group.
• Although a much lower proportion of people aged 70 years and over were working, a higher proportion of these were working part-time. The proportion of men working part-time was much higher for those aged 70 years and over (at 56%), compared with 8% of 45–49 year olds. For women, the proportion working part-time was 83% in the 70 years and over age group, compared with 42% for those aged 45–49 years (ABS 2008a).

Male employment, March 2008	Female employment, March 2008

• The retention of mature age workers for longer before retirement allows employers to benefit from their skills and experience. Retiring at an older age can also improve the financial security of the worker in retirement. For older workers, financial incentives related to taxation as well as public pension and superannuation schemes play an important role in shaping retirement decisions. In 2006–07, Australians aged 45 years and over who had retired in the past 10 years on average had left work at 58 years of age, those who retired in the past 5 years on average had left at 60 years and those intending to retire planned on average to retire at 63 years (ABS 2008b).

• Labour force participation rates are consistently lower for people with chronic conditions and as people age, they are more likely to have a chronic NHPA condition or injury. NHPAs are diseases and conditions chosen because of their significant contribution to the burden of disease and injury in Australia – arthritis or osteoporosis, asthma, cancer, cardiovascular disease, diabetes, injury, mental health and obesity. In 2004–05, the average number of NHPA conditions present within an age cohort increased from 0.2 in those aged 0–14 years to 2.7 in the 75 years and over age group.

Average number of NHPA conditions, 2004–05

• In the year to June 2007, 40% of workers aged 45 years and over expected personal health or physical abilities to be a major factor influencing decisions about when they were going to retire. However, financial security (42%) was a slightly more major factor influencing the decision about when to retire by this age group who intended to retire from the labour force (ABS 2008b). Of people aged 45 years and over who were not in the labour force in September 2007 but wanted to work (footnote 5), 19% reported 'own long-term ill health or disability' as the main reason for not actively looking for work (ABS 2008c).
• A higher proportion of people aged 45–74 years, who were not in the labour force in 2004–05, had an NHPA condition (89%) compared with those in the same age group who were in the workforce (79%).
• In 2004–05, the most prevalent NHPA conditions among people aged 45–74 years were overweight or obesity (57%), arthritis or osteoporosis (35%) and cardiovascular disease (34%). These were also the most common NHPA conditions of mature age workers (58%, 25% and 25% respectively). Although a similar proportion of people aged 45–74 years not in the labour force were overweight or obese (55%), a higher proportion of this group had arthritis or osteoporosis (49%), or cardiovascular disease (46%).
• Different profiles are evident when the prevalence of conditions and workforce participation are examined within the three ten-year age cohorts (between 45 and 74). In the 45–54 years age group it is more likely for people to be employed than not be in the labour force for each of the NHPA conditions, whereas for the 55–64 years age group, similar proportions were employed and not in the labour force. For those in the 65–74 years age group, most are no longer in the labour force.
• For example, among people aged 45–74 years with diabetes, people in the 45–54 year old age group were most likely to be working (76%), followed by those in the 55–64 year old age group (39%).
  

Proportion of 45–74 year olds with NHPA conditions who were mature age workers, 2004–05

• Younger mature age workers with NHPA conditions were also more likely to be working full-time than their older counterparts. The most notable difference in the proportion of people with NHPA conditions who were working full-time (footnote 6) was between the 55–59 years age group (44%) and the 60–64 years age group (23%). There was also considerable difference between those aged 60–64 (23%) compared with 8% in the 65–69 years age group. This partly reflects the age of eligibility for the Age Pension (65 years for men and early 60s for women (the age that women are eligible for the Age Pension is increasing gradually to be the same as men, at 65 years)).
• Among male mature age workers with NHPA conditions, the proportion who were employed full-time rather than part-time was higher in the 45–49 years age group (94%), compared with 26% in the 70–74 years age group. The difference for these age groups for employed females was 57% compared with 21% respectively, reflecting that women of all ages are more likely than men to work part-time.

• Self-assessed health status is considered to be a strong predictor of morbidity and mortality (Gerdtham et al 1999 and McCallum et al 1994).
• Among mature age workers who reported an NHPA condition, more than half (56%) assessed their health in 2004-05 as very good or excellent, compared with 31% of those with an NHPA condition who were not in the labour force. The same proportion (56%) of mature age workers with NHPA conditions who worked part-time and those who worked full-time thought their health was very good or excellent.
• Mature age shift workers with NHPA conditions (51%) were less likely than other workers with NHPA conditions to assess their health as very good or excellent (57%).

• Risk factors are characteristics that are associated with an increased risk of developing a particular disease or condition (AIHW 2006). Lifestyle risk factors such as overweight and obesity, risky levels of alcohol consumption, daily tobacco smoking and inadequate physical activity increase the risk of ill health, but unlike other factors such as age and sex, are behaviourally modifiable (footnote 7). Thus, the incidence and severity of some diseases and illnesses can be significantly lowered by reducing contributing risk factors, including lifestyle choices (PC 2007).
• In 2004–05, the most common lifestyle risk factors among mature age workers with NHPA conditions were inadequate intake of fruit or vegetables (86%), being overweight or obese (73%) and sedentary or low physical activity (72%). These were similar to proportions of those for people aged 45–74 years who were not in the labour force with NHPAs (inadequate intake of fruit or vegetables (86%), sedentary or low physical activity (71%) and being overweight or obese (63%)).

Lifestyle risk factors of people aged 45–74 years with NHPA conditions, 2004–05

• One advantage of retaining mature age workers in the workforce is that it assists in maintaining a level of expertise which would otherwise be lost. There is evidence that most workers have the potential to remain productive up to and beyond current standard retirement ages, provided they receive adequate training (OECD 1998).
• People in this age group with NHPAs who were not in the labour force were less likely to have a non-school qualification (footnote 8) (64%) than mature age workers (39%). Further, mature age workers with NHPA conditions in 2004–05 were more likely to have a bachelor degree or higher qualification (19%) than people aged 45–74 years with NHPA conditions who were not in the labour force (7%).

People aged 45–74 years with NHPA conditions by highest non-school qualifications (a), 2004–05

• In 2004–05, 5% of mature age workers with an NHPA condition were studying compared with 1% of those not in the labour force of a similar age.

• Mature age workers living in capital cities (77%) were less likely to have NHPA conditions than those living outside of capital cities (83%).
• In 2004–05, the Australian Capital Territory (84%) and Tasmania (82%) had the highest proportions of mature age workers with NHPA conditions, while Victoria and Queensland (both 78%) had the lowest proportions.
• People living in areas of greater socio-economic disadvantage (footnote 9) have higher prevalence rates of nearly all chronic diseases. For example, in 2004–05, workers aged 45–74 years living in areas of greater socio-economic disadvantage were more likely to have NHPA conditions (81%) than those living in the least disadvantaged areas (78%).

• As the labour force ages (along with population), industries which have higher proportions of mature age workers are the most likely to be affected by their loss. For example, in 2004–05, half of all people working in the Agriculture, fishing and forestry industry (footnote 10) were aged 45–74 years. This is consistent with the trend for fewer young people to enter farming as a vocation and with farmers often working beyond the age of 65 years (ABS 2003).
• There were also differences in the proportions of mature age workers who reported an NHPA condition across industries, from 73% in the Communication services industry to 93% in the Mining industry.
• The industry with the highest proportion of mature age workers who had NHPA conditions was the Mining industry (93%).
• NHPA conditions were most common among female mature age workers in the Communication services, and Electricity, gas and water supply industries (both 88%).

	Total employed all ages ('000)	Proportion 45–74 years (%)	Proportion of those aged 45–74 years who had NHPA conditions (%)
			Persons	Men	Women
Agriculture, fishing and forestry	420.2	49.7	78.4	81.7	71.4
Mining	117.9	38.4	92.6	93.4	87.1
Manufacturing	1,056.3	34.5	78.5	82.8	68.3
Electricity, gas and water supply	85.1	46.3	90.0	90.3	88.1
Construction	864.1	33.0	83.1	83.1	83.3
Wholesale trade	438.4	36.8	75.9	79.2	70.5
Retail trade	1,575.8	23.7	81.4	87.4	75.4
Accommodation, cafes and restaurants	435.0	22.3	76.2	74.1	77.6
Transport and storage	493.3	47.5	78.8	80.1	71.6
Communication services	181.7	30.0	73.2	69.2	88.4
Finance and insurance	399.5	26.7	75.4	72.0	78.6
Property and business services	1,210.5	36.3	78.4	83.3	69.7
Government administration and defence	503.5	40.7	81.8	85.7	77.6
Education	605.2	45.8	75.8	77.7	75.0
Health and community services	1,009.8	45.0	75.1	82.7	73.0
Cultural and recreational services	307.7	26.7	86.2	88.5	83.4
Personal and other services	352.0	28.6	85.0	87.6	80.1
Total Industries	10,055.9	35.1	79.0	82.6	74.3

• Many occupations (footnote 11) with high proportions of mature age workers are those requiring higher skill levels. This partly reflects the time it takes to gain the skills and experience to be promoted to many of these jobs. In 2004–05, the occupation group with the highest proportion of workers aged 45–74 years were Managers and administrators (52%).
• In 2004–05, for mature age workers who reported an NHPA condition, prevalence of these conditions ranged from 75% among Professionals to 84% among Tradespersons and related workers.
• The proportion of people with NHPA conditions also varied by gender across occupations, with proportions generally higher in men than in women. In 2004–05, Intermediate clerical, sales and service workers (87%) and Associate professionals (85%) were the occupations with the highest proportions of male mature age workers with NHPA conditions. The occupations with the highest proportions of female workers aged 45–74 years who had NHPA conditions were Tradespersons and related workers (83%) and Advanced clerical and service workers (81%).

	Total employed all ages ('000)	Proportion 45–74 years (%)	Proportion of those aged 45–74 years who had NHPA conditions (%)
			Persons	Men	Women
Managers and administrators	985.5	51.6	80.3	83.4	70.7
Professionals	1,878.5	36.6	74.8	82.5	67.6
Associate professionals	1,234.4	37.1	81.6	85.4	76.4
Tradespersons and related workers	1,225.1	30.2	83.6	83.7	83.1
Advanced clerical and service workers	333.5	39.3	81.0	*81.5	80.9
Intermediate clerical, sales and service workers	1,658.1	32.3	80.2	86.5	77.8
Intermediate production and transport workers	861.6	36.9	76.7	79.1	59.5
Elementary clerical, sales and service workers	956.4	22.1	75.6	78.0	74.2
Labourers and related workers	848.0	33.7	77.6	77.2	78.1
Total Occupations (b)	10,055.9	35.1	79.0	82.6	74.3

• The proportions of mature age workers with and without an NHPA condition who worked full-time were similar (71% and 69% respectively). However, younger mature age workers with NHPA conditions aged 45–54 years were more likely to work full-time (76%) than mature age workers in this age group without an NHPA condition (71%).
• In 2004–05, more than half (54%) of full-time workers aged 45–74 years with NHPA conditions were full-time workers who worked 41 hours or more per week.
• Around 39% of mature age workers with NHPA conditions working full-time worked very long hours (that is 49 hours or more per week), compared with 40% for those without an NHPA condition.

• Workplace injuries and illnesses range in severity and may cause short-term or long-term pain, disability or death. Absence from work or the loss of income or job may also be a consequence of these injuries and illnesses (ABS 2006a). The National Occupational Health and Safety Commission has estimated that the total costs of workplace injury and illness to the Australian economy for 2000–01 to be $34.3 billion (NOHSC 2004).
• In 2004–05, 7% of people aged 45–74 years reported a work-related NHPA chronic disease (that is arthritis or osteoporosis, asthma, cancer, cardiovascular disease, diabetes or mental health conditions), compared with 3% of people aged 15–44 years.
• Men aged 45–74 years (9%) were more likely than women (6%) in 2004–05 to report a work-related long-term NHPA disease.
• In 2004–05, the two NHPA chronic diseases in people aged 45–74 years which were most likely to be work-related were mental and behavioural problems (17%) and arthritis or osteoporosis (9%). However, the proportion of work-related mental and behavioural problems in mature age workers (21%) was much higher compared with those not in the labour force (12%).
• The long-term NHPA diseases in people aged 15–44 years which were most likely to be work-related were also mental and behavioural problems (16%) and arthritis or osteoporosis (11%).
• Long-term conditions of people aged 45–74 years which were most likely to be work-related but which are not NHPA chronic diseases include disc disorders (42%), back pains and problems (41%), and partial deafness and hearing loss (32%).

• In 2005–06, an estimated 6% of people aged 45 years and over experienced a work-related injury or illness in the previous 12 months (ABS 2006b).
• Of all employed people aged 45–74 years in 2004–05, 1% reported a long-term NHPA disease caused by a work-related injury. A similar proportion of people aged 45–74 years who were not in the labour force had a long-term NHPA disease caused by a work-related injury (1%). Younger workers were less likely than mature age workers to have a long-term NHPA disease caused by a work-related injury (0.3%).
• In 2004–05, arthritis or osteoporosis together were the most likely work-related long-term NHPA diseases to have been caused by a work-related injury. Of those aged 45–74 years with these diseases, 3% were caused by a work-related injury. Arthritis or osteoporosis were also the most common NHPA diseases for 15–44 year olds to have been caused by a work-related injury (4%).
• People whose occupations involved physical work were at a higher risk of experiencing a work-related injury or illness. Of employed people aged 45 years and over, in 2005–06 the highest proportions were experienced by people who had worked as Labourers and related workers (12%), and Intermediate production and transport workers (10%) in the previous 12 months (ABS 2006b).

Occupation of people(a) who experienced a work-related injury or illness (b), 2005–06

• In 2005–06, approximately 29% of people aged 45 years and over who had worked some time in the previous 12 months and experienced a work-related injury or illness received workers' compensation, representing 86% of those who applied for workers' compensation (ABS 2006b).
  

• Health promotion and disease prevention initiatives are aimed at improving the health of the community, leading to a reduction in chronic disease. This may also lead to increased labour force participation. In 2003, people aged 45–74 years comprised 31% of the Australian population and experienced 42% of the total burden of disease and injury (footnote 12) (Begg S. et al 2007). Since most of the modifiable risk factors are associated with several different diseases, prevention and management of these factors can have substantial benefits (AIHW 2006).
• Poor health can impact on an employee's productivity through both the time that they are absent from work because of ill health, and the times that they are at work but operating at reduced capacity. Among employed people aged 15–64 years, 30% of days away from work in the two weeks before the interview were by workers aged 45–64 years who reported having an NHPA condition. Three quarters of these days away from work were by workers aged 45–64 years who worked full-time. Note that although the reason for having the day away was related to the person's illness, that illness may not be related to their NHPA condition.
• Day clinics (footnote 13), general practitioners (GPs) and specialists are elements of the health system which focus on preventing and managing conditions. Although in the 2004–05 NHS information related to the reason for a visit was not collected, of the mature age workers who reported having an NHPA condition, 20% visited a day clinic and 12% consulted a GP or specialist in the two weeks prior to the interview. People aged 45–74 years who were not in the labour force and reported an NHPA condition were more likely to have taken these health related actions as 35% visited a day clinic and 16% consulted a GP or specialist.
• People aged 45–74 years with cancer were more likely to visit a day clinic, GP or specialist in the previous two weeks (44% of mature age workers with cancer and 67% of those not in the labour force with cancer) than people of this age group with other NHPA conditions. People aged 45–74 years with diabetes also used these health services frequently (43% and 58% respectively). In general, people with NHPA conditions who were not in the labour force accessed day clinics, GPs and specialists more than mature age workers, irrespective of their age cohort.

Action taken (a) by people aged 45–74 years with NHPA conditions, 2004–05

• Arthritis and Musculoskeletal conditions - measured in this snapshot by arthritis and osteoporosis.
• Asthma
• Cancer Control – malignant neoplasms only
• Cardiovascular Health, or diseases of the circulatory system
• Diabetes mellitus
• Injury Prevention and Control - measured in this snapshot by long-term conditions caused by injury
• Mental health – mental and behavioural problems
• Obesity – overweight or obese, with a body mass index score of 25 and over (see Lifestyle risk factors below).

• Current daily smoker – an adult who reported that they regularly smoked one or more cigarettes, cigars or pipes per day at the time of the survey. See Chapter 4, page 75 of the 2004–05 National Health Survey: Users' Guide (cat. no. 4363.0.55.001).
• Overweight or obese – calculated from reported height and weight information, using the formula weight (kg) divided by the square of height (m). To produce a measure of the prevalence of overweight or obesity in people aged 45–74 years, body mass index (BMI) values are grouped, allowing categories to be reported against both the World Health Organization (WHO) and National Health and Medical Research Council (NHMRC) guidelines. See Chapter 4, page 87 of the 2004–05 National Health Survey: Users' Guide (cat. no. 4363.0.55.001) for detailed information on BMI.
• Risky/high risk alcohol consumption – alcohol risk levels were derived from the average daily consumption of alcohol in the seven days prior to interview and were grouped into relative risk levels as defined by the National Health and Medical Research Council (NHMRC). See Chapter 4, page 77 of the 2004–05 National Health Survey: Users' Guide (cat. no. 4363.0.55.001).
• Sedentary/low physical activity – based on frequency, intensity (i.e. walking, moderate exercise and vigorous exercise) and duration of exercise (for recreation, sport or fitness) in the two weeks prior to the interview. From these components, an exercise score was derived using factors to represent the intensity of the exercise. See Chapter 4, page 83 of the 2004–05 National Health Survey: Users' Guide (cat. no. 4363.0.55.001).
• Inadequate intake of fruit or vegetables – refers to the intake of less than two serves of fruit or less than five serves of vegetables per day for adults. See Chapter 4, page 90 of the 2004–05 National Health Survey: Users' Guide (cat. no. 4363.0.55.001).