Loretta PlattsDocent, Forskare
Loretta G. Platts bedriver forskning inom folkhälsa och socialgerontologi med inriktning mot arbetsmiljö. Hon forskar om livskvalitet, hälsa, pensionsprocesser och lönearbete efter pensionering. Hennes publicerade forskning handlar om ojämlikheter i hälsa och livskvalitet från ett livsloppsperspektiv, inklusive skillnader i livskvalitet senare i livet hos personer som tidigare utsatts för fysiska påfrestningar på jobbet. Loretta har omfattande erfarenhet av att arbeta med stora, longitudinella enkäter och administrativ data, och har nyligen påbörjat ett kvalitativt forskningsprogram.
Lorettas pågående forskning handlar om lönearbete efter pensionering i Sverige, USA och Japan, med fokus på dess betydelse för hälsa och inkomst. Hon leder projekt finansierade av Forte, Riksbankens Jubileumsfond och Familjen Kamprads stiftelse.
Imperial College London (med.dr), Sciences Po Paris (masterexamen), University of Oxford (kandidatexamen).
I urval från Stockholms universitets publikationsdatabas
Changes in Job Quality as People Work Beyond Pensionable Age in Sweden
2021. Lawrence B. Sacco (et al.). Work, Aging and RetirementArtikel
Large numbers of people remain in paid work after pensionable age, often in bridge jobs or with reduced working hours. Remarkably, knowledge about the quality of these jobs relative to those taken prior to pension eligibility is very limited. In this paper, we examined changes in job quality among workers in their sixties in the context of contemporaneous changes in work intensity and employment characteristics. This study is based on data from the biennial Swedish Longitudinal Occupational Survey of Health (SLOSH, 2006–2018, n = 1890–3013). Job quality outcomes were physical (dangerous, strenuous or unpleasant work) and psychosocial (job strain, effort-reward imbalance, work time control) working conditions and job satisfaction. First difference estimation was used to observe within-individual wave-to-wave changes in job quality over ages 61/62–69/70. Changes in working hours, employment characteristics (shifting to a non-permanent contract, the private sector and self-employment) and health were included as covariates. The typical individual who worked beyond pensionable age experienced statistically significant improvements in job quality. Improvements in psychosocial working conditions and job satisfaction were larger for those who reduced working hours and shifted from permanent to non-permanent contracts, from the public into the private sector and from wage-and-salary to self-employment. Work beyond pensionable age is a distinctive period, characterized by employment that becomes more flexible and rewarding and less stressful. These improvements are a function of older individuals’ preferences and ability to work fewer hours and transition to new lines of work.
How does work impact daily sleep quality? A within-individual study using actigraphy and self-reports over the retirement transition
2021. Johanna Garefelt (et al.). Journal of Sleep ResearchArtikel
This study examined how the cessation of work at retirement affects daily measures of actigraphy-measured and self-rated sleep quality. Time in bed or asleep and stress at bedtime were examined as potential mechanisms. In total 117 employed participants who were aged 60-72 years and planned to retire soon were recruited to the Swedish Retirement Study. Sleep quality was measured in a baseline week using accelerometers, diaries, and questionnaires. Subjective sleep measures were sleep quality, restless sleep, restorative sleep, getting enough sleep, estimated wake after sleep onset, difficulties falling asleep, too early final awakening, and difficulties waking up. Actigraphy measures were sleep efficiency, wake after sleep onset, and average awakening length. After 1 and 2 years, the measurements were repeated for the now retired participants. Daily variations in sleep quality before and after retirement were analysed using multilevel modelling, with time in bed or asleep and stress at bedtime as potential mediators. We found that several self-reports of sleep improved (e.g., +0.2 standard deviations for sleep quality and +0.5 standard deviations for restorative sleep) while objective sleep quality remained unchanged or decreased slightly with retirement (e.g., -0.8% for sleep efficiency). Increased time in bed or asleep and stress at bedtime accounted partially for the improvements in self-rated sleep quality at retirement. In conclusion, actigraph-measured and self-reported sleep quality do not change in concert at retirement, highlighting the interest of studying both outcomes. The main effects of retirement from work concern subjective experiences of recovery more than sleep quality per se.
The nature of paid work in the retirement years
2021. Loretta G. Platts (et al.). Ageing & SocietyArtikel
Ever more people are in paid work following the age of state pension availability, and yet the experience of working in this phase of the late career has been little studied. We interviewed a purposive sample of 25 Swedish people in their mid- to late sixties and early seventies, many of whom were or had recently been working while claiming an old-age pension. The data were analysed with constant comparative analysis in which we described and refined categories through the writing of analytic memos and diagramming. We observed that paid work took place within a particular material, normative and emotional landscape: a stable and secure pension income decommodifying these workers from the labour market, a social norm of a retired lifestyle and a looming sense of contraction of the future. This landscape made paid work in these years distinctive: characterised by immediate intrinsic rewards and processes of containing and reaffirming commitments to jobs. The oldest workers were able to craft assertively the temporal flexibility of their jobs in order to protect the autonomy and freedom that retirement represented and retain favoured job characteristics. Employed on short-term (hourly) contracts or self-employed, participants continually reassessed their decision to work. Participation in paid work in the retirement years is a distinctive second stage in the late career which blends the second and third ages.
How consistently does sleep quality improve at retirement? Prospective analyses with group-based trajectory models
2021. Paraskevi Peristera (et al.). Journal of Sleep ResearchArtikel
Growing evidence indicates that retiring from paid work is associated, at least in the short-term, with dramatic reductions in sleep difficulties and more restorative sleep. However, much is still not known, in particular how universal these improvements are, how long they last, and whether they relate to the work environment. A methodological challenge concerns how to model time when studying abrupt changes such as retirement. Using data from Swedish Longitudinal Occupational Survey of Health (n = 2,148), we studied difficulties falling asleep, difficulties maintaining sleep, premature awakening, restless sleep, a composite scale of these items, and non-restorative sleep. We compared polynomial and B-spline functions to model time in group-based trajectory modelling. We estimated variations in the individual development of sleep difficulties around retirement, relating these to the pre-retirement work environment. Reductions in sleep difficulties at retirement were sudden for all outcomes and were sustained for up to 11 years for non-restorative sleep, premature awakening, and restless sleep. Average patterns masked distinct patterns of change: groups of retirees experiencing greatest pre-retirement sleep difficulties benefitted most from retiring. Higher job demands, lower work time control, lower job control, and working full-time were work factors that accounted membership in these groups. Compared to polynomials, B-spline models more appropriately estimated time around retirement, providing trajectories that were closer to the observed shapes. The study highlights the need to exercise care in modelling time over a sudden transition because using polynomials can generate artefactual uplifts or omit abrupt changes entirely, findings that would have fallacious implications.
How does cessation of work affect sleep? Prospective analyses of sleep duration, timing and efficiency from the Swedish Retirement Study
2021. Johnna Garefelt (et al.). Journal of Sleep Research 30 (3)Artikel
Several strands of research indicate that work competes for time with sleep, but to what extent the timing and duration of sleep is affected by work is not known. Retirement offers a quasi-experimental life transition to study this in a within-individual study design. The few existing studies report that people sleep longer and later after retirement but mainly rely on self-reported data or between-individual analyses. We recruited 100 participants aged 61–72 years who were in paid work but would soon retire and measured them in a baseline week with accelerometers, diaries and questionnaires. After 1 and 2 years, the measurements were repeated for the now retired participants. Changes in sleep duration, timing, efficiency, chronotype and social jetlag were analysed using multilevel modelling. Gender, chronotype at baseline and partner's working status were analysed as potential effect modifiers. Sleep duration increased by 21 min, whereas sleep efficiency remained similar. Time of sleep onset and final awakening were postponed by 26 and 52 min, respectively, pushing midsleep forward from 03:17 to 03:37 hours. Changes in duration and timing of sleep were driven by weekday sleep, whereas weekend sleep stayed about the same. Social jetlag decreased but still occurred after retirement. Changes at retirement in sleep duration and timing were smaller for participants with a later chronotype and who had full-time working partners. These findings indicate that paid work generates sleep loss and hinders people from sleeping in line with their biological time.
An Increasing Incidence of Upper Gastrointestinal Disorders Over 23 Years
2021. Anna Andreasson (et al.). American Journal of Gastroenterology 116 (1), 210-213Artikel
INTRODUCTION: We hypothesized that the prevalence of functional dyspepsia and gastroesophageal reflux disease in the community may be increasing.
METHODS: Randomly selected adults were surveyed on 4 occasions: 1988 (n = 1,151, 21–79 years, response rate [rr] = 90%), 1989 (n = 1,097, 22–80 years, rr = 87%), 1995 (n = 1,139, 20–85 years, rr = 76%), and 2011 (n = 1,175, 20–93 years, rr = 63%).
RESULTS: In functional dyspepsia, the odds of postprandial distress syndrome tripled over 23 years' follow-up (odds ratio [OR]: 3.55; 95% confidence interval [CI]: 2.60–4.84, mixed-effect regression analysis), whereas a small decrease in epigastric pain syndrome was observed (OR: 0.65, 95% CI: 0.42–1.00). The odds of reporting gastroesophageal reflux disease doubled (OR: 2.02; 95% CI: 1.50–2.73).
DISCUSSION: The underlying mechanisms behind the increase in postprandial distress syndrome and gastroesophageal reflux disease remain to be determined.
Sickness absence and sickness presence in relation to office type
2020. Loretta Platts (et al.). PLOS ONE 15 (4)Artikel
Objectives: Previous research suggesting that open-plan office environments are associated with higher rates of sickness absence rely on self-reports which can be affected by recall bias. This paper investigates the associations of sickness absence, obtained from employer records as well as self-reports, with office type (cell offices and different sizes of open-plan offices). It additionally studies whether office type is associated with sickness presence.
Methods: Employees from two private and one public sector organization were recruited to the study. Office type was ascertained by direct observation or from employee responses to an online survey. Control variables were gender, age, public/private sector and education level. Number of days and episodes of sickness absence were calculated from employer absence records and regressed on office type using negative binomial regression (n = 988). Self-reports of sickness absence and presence were regressed on office type using ordered logistic regression (n = 1237).
Results: Office type was generally not associated with employer records of number of episodes or days of sickness absence, except that the total number of days of leave was higher in flex offices compared to cell offices (IRR = 2.46, p = 0.007). In general, office type was not associated with self-reported days of sickness absence, apart from participants working in medium-sized open-plan offices who had 0.42 higher log-odds of absence than those working in cell offices (p = 0.004). Office type was not associated with self-reported sickness presence.
Conclusions: Office type was not associated with sickness presence nor, in general, with sickness absence, whether obtained from self-reports or company records. It is not possible to conclude from this study that open-plan offices are associated with greater sickness absence or sickness presence compared to cell offices.
Omvärdera synen på de äldres livsvillkor under pandemin
2020. Loretta G. Platts, Lawrence B. Sacco, Boo Johansson. LäkartidningenArtikel
Rekommendationen att alla äldre personer ska hålla sig hemma är ett uttryck för negativa stereotyper som utgår ifrån att äldre är passiva, sårbara och beroende av andra. Den riskerar att ytterligare begränsa personlig frihet och förstärka den sociala, ekonomiska och politiska marginaliseringen. Åtgärder för att skydda äldre från covid-19 behöver inriktas på hur vi kan främja ett aktivt, meningsfullt och tillfredsställande liv trots pandemin. Bättre kunskap om äldres livsvillkor behövs alltså som grund för nya rekommendationer. Vi föreslår att
- äldre engageras (enskilt eller via pensionärsorganisationer) i diskussioner om hur man realistiskt och varaktigt kan skydda sig utan att behöva vara isolerad
- äldre människors olika livsvillkor och levnadsförhållanden beaktas i nya och hälsofrämjande rekommendationer
- nya rekommendationer måste stärka de äldres egen handlingskraft
- nya rekommendationer ger bättre underlag för att väga riskerna för covid-19 mot ett hälsofrämjande socialt och fysiskt aktivt liv.
Informal Caregiving and Quality of Life Among Older Adults
2020. Lawrence B. Sacco (et al.). Social Indicators ResearchArtikel
Providing unpaid informal care to someone who is ill or disabled is a common experience in later life. While a supportive and potentially rewarding role, informal care can become a time and emotionally demanding activity, which may hinder older adults’ quality of life. In a context of rising demand for informal carers, we investigated how caregiving states and transitions are linked to overall levels and changes in quality of life, and how the relationship varies according to care intensity and burden. We used fixed effects and change analyses to examine six-wave panel data (2008–2018) from the Swedish Longitudinal Occupational Survey of Health (SLOSH, n = 5076; ages 50–74). The CASP-19 scale is used to assess both positive and negative aspects of older adults’ quality of life. Caregiving was related with lower levels of quality of life in a graded manner, with those providing more weekly hours and reporting greater burden experiencing larger declines. Two-year transitions corresponding to starting, ceasing and continuing care provision were associated with lower levels of quality of life, compared to continuously not caregiving. Starting and ceasing caregiving were associated with negative and positive changes in quality of life score, respectively, suggesting that cessation of care leads to improvements despite persistent lower overall levels of quality of life. Measures to reduce care burden or time spent providing informal care are likely to improve the quality of life of older people.
How does cessation of work affect sleep?
2020. Johanna Garefelt (et al.). Journal of Sleep ResearchArtikel
Several strands of research indicate that work competes for time with sleep, but to what extent the timing and duration of sleep is affected by work is not known. Retirement offers a quasi-experimental life transition to study this in a within-individual study design. The few existing studies report that people sleep longer and later after retirement but mainly rely on self-reported data or between-individual analyses. We recruited 100 participants aged 61-72 years who were in paid work but would soon retire and measured them in a baseline week with accelerometers, diaries and questionnaires. After 1 and 2 years, the measurements were repeated for the now retired participants. Changes in sleep duration, timing, efficiency, chronotype and social jetlag were analysed using multilevel modelling. Gender, chronotype at baseline and partner's working status were analysed as potential effect modifiers. Sleep duration increased by 21 min, whereas sleep efficiency remained similar. Time of sleep onset and final awakening were postponed by 26 and 52 min, respectively, pushing midsleep forward from 03:17 to 03:37 hours. Changes in duration and timing of sleep were driven by weekday sleep, whereas weekend sleep stayed about the same. Social jetlag decreased but still occurred after retirement. Changes at retirement in sleep duration and timing were smaller for participants with a later chronotype and who had full-time working partners. These findings indicate that paid work generates sleep loss and hinders people from sleeping in line with their biological time.
Reciprocal relations between work stress and insomnia symptoms
2020. Johanna Garefelt (et al.). Journal of Sleep Research 29 (2)Artikel
Work stress and poor sleep are closely related in cross-sectional data, but evidence from prospective data is limited. We analysed how perceived stress and work stressors (work demands, decision authority and workplace social support) are related to key dimensions of insomnia over time, using structural equation modelling. Biennial measurements from a large sample of the working population in Sweden enabled us to analyse both the relationship from stress to sleep as well as that from sleep to stress. Overall, we found reciprocal relations between insomnia and all four stress measures. However, looking at the relation between each dimension of insomnia and each stress measure, there were some differences in direction of effects. In the direction from stress to sleep, all work stressors as well as perceived stress predicted both difficulties initiating sleep and difficulties maintaining sleep. The same was found for non-restorative sleep, with the exception for decision authority. In the opposite direction, difficulties maintaining sleep predicted increased levels of work demands and perceived stress. Difficulties initiating sleep stood out among the insomnia symptoms as not predicting any of the stress measures, while non-restorative sleep was the only symptom predicting all stress measures. The results advance the understanding of the stress-sleep relationship and indicate a potential vicious circle between insomnia and perceived stress as well as work stressors, suggesting that the workplace could be an arena for interventions to alleviate insomnia.
Reduction in sleep disturbances at retirement
2019. Vera van de Straat (et al.). Ageing & SocietyArtikel
Although retirement involves a radical change in daily activities, income, social roles and relationships, and the transition from paid work into retirement can, therefore, be expected to affect sleep, little is known about the effects of old-age retirement on changes in sleep disturbances, and how the impact of retirement may vary by gender, age and prior working conditions. This study modelled reported sleep disturbances up to nine years before to nine years following retirement in a sample of 2,110 participants from the Swedish Longitudinal Occupational Survey of Health (SLOSH). Sleep disturbances over the retirement transition were modelled using repeated-measures regression analysis with Generalized Estimating Equations (GEE) in relation to gender, age at retirement, working patterns (night work, full-time/part-time work), control over work hours, and psychological and physical working conditions. The analyses controlled for civil status, education level, income obtained from registers and self-rated health. Retiring from paid work was associated with decreased sleep disturbances. Greater reductions in sleep disturbances were reported by women, as well as by participants who retired before age 65 years, who were working full-time, who lacked control over their work hours and who had high psychological demands. These results, suggesting that old-age retirement from paid work is associated with reductions in disturbed sleep, pose a challenge for governments seeking to increase retirement ages.
A comparison of the B-spline group-based trajectory model with the polynomial group-based trajectory model for identifying trajectories of depressive symptoms around old-age retirement
2018. Paraskevi Peristera (et al.). Aging & Mental HealthArtikel
Objectives: The life event of retirement may be associated with changes in levels of depressive symptoms. The use of polynomial group-based trajectory modelling allows any changes to vary between different groups in a sample. A new approach, estimating these models using B-splines rather than polynomials, may improve modelling of complex changes in depressive symptoms at retirement.
Methods: The sample contained 1497 participants from the Swedish Longitudinal Occupational Survey of Health (SLOSH). Polynomial and B-spline approaches to estimating group-based trajectory models were compared.
Results: Polynomial group-based trajectory models produced unexpected changes in direction of trajectories unsupported by the data. In contrast, B-splines provided improved insights into trajectory shapes and more homogeneous groups. While retirement was associated with reductions in depressive symptoms in the sample as a whole, the nature of changes at retirement varied between groups.
Conclusions: Depressive symptoms trajectories around old age retirement changed in complex ways that were modelled more accurately by the use of B-splines. We recommend estimation of group-based trajectory models with B-splines, particularly where abrupt changes might occur. Improved trajectory modelling may support research into risk factors and consequences of major depressive disorder, ultimately assisting with identification of groups which may benefit from treatment.
Job strain and loss of healthy life years between ages 50 and 75 by sex and occupational position
2018. Linda L. Magnusson Hanson (et al.). Occupational and Environmental Medicine 75 (7), 486-493Artikel
Objectives Poor psychosocial working conditions increase the likelihood of various types of morbidity and may substantially limit quality of life and possibilities to remain in paid work. To date, however, no studies to our knowledge have quantified the extent to which poor psychosocial working conditions reduce healthy or chronic disease-free life expectancy, which was the focus of this study.
Methods Data were derived from four cohorts with repeat data: the Finnish Public Sector Study (Finland), GAZEL (France), the Swedish Longitudinal Occupational Survey of Health (Sweden) and Whitehall II (UK). Healthy (in good self-rated health) life expectancy (HLE) and chronic disease-free (free from cardiovascular disease, cancer, respiratory disease and diabetes) life expectancy (CDFLE) was calculated from age 50 to 75 based on 64394 individuals with data on job strain (high demands in combination with low control) at baseline and health at baseline and follow-up.
Results Multistate life table models showed that job strain was consistently related to shorter HLE (overall 1.7 years difference). The difference in HLE was more pronounced among men (2.0 years compared with 1.5 years for women) and participants in lower occupational positions (2.5 years among low-grade men compared with 1.7 years among high-grade men). Similar differences in HLE, although smaller, were observed among those in intermediate or high occupational positions. Job strain was additionally associated with shorter CDFLE, although this association was weaker and somewhat inconsistent.
Conclusions These findings suggest that individuals with job strain have a shorter health expectancy compared with those without job strain.
Informal care and sleep disturbance among caregivers in paid work
2018. Lawrence B. Sacco, Constanze Leineweber, Loretta G. Platts. Sleep 41 (2), 1-10Artikel
To examine cross-sectionally and prospectively whether informal caregiving is related to sleep disturbance among caregivers in paid work.
Participants (N=21 604) in paid work from the Swedish Longitudinal Occupational Survey of Health. Sleeping problems were measured with a validated scale of sleep disturbance (Karolinska Sleep Questionnaire). Random-effects modelling was used to examine the cross-sectional association between informal caregiving (self-reports: none, up to 5h per week, over 5h per week) and sleep disturbance. Potential socio-demographic and health confounders were controlled for and interactions between caregiving and gender included. Longitudinal random-effects modelling of the effects of changes in reported informal caregiving upon sleep disturbance and change in sleep disturbance were performed.
In multivariate analyses controlling for socio-demographics, health factors and work hours, informal caregiving was associated cross-sectionally with sleep disturbance in a dose-response relationship (compared to no caregiving, up to 5h of caregiving: β = .03; 95% CI: .01; .06, over 5h: β = .08; 95% CI: .02; .13), results which varied by gender. Cessation of caregiving was associated with reductions in sleep disturbance (β = -.08; 95% CI: -.13; -.04).
This study provides evidence for a causal association of provision of informal care upon subjective sleep disturbance. Even low intensity care provision was related to sleep disturbance among this sample of carers in paid work. The results highlight the importance of addressing sleep disturbance in caregivers.