OBJECTIVES

: This study describes the association between multimorbidity (MM) and perceived working conditions across Europe.

METHODS

: We used data from the last wave of the Survey of Health, Ageing and Retirement in Europe (SHARE,2015). The sample comprises all employees aged 50-65 (N=14,334). We used the effort–reward (ER) model as an indicator of work environment. The ER ratio results from the ratio of the sum of scores on the effort and reward dimensions. An ER ratio >1 (i.e.,ER Imbalance[ERI]) indicates perceived negative working conditions. We model ERI as a function of MM (≥2 chronic conditions), adjusting for age, gender and education level, using logistic models with country fixed effects.

RESULTS

: In Europe, 47.6% of MM workers were more likely to report work imbalance than non-MM workers (36.1%,p<0.001). While MM workers from some EU countries (LU,SE,CH,DK,BE,AT) were more likely to report a positive working environment, others (DE,SP,EE,FR,GR,PT,CZ,SL,IT,PL) were more prone to report a negative one. The MM/non-MM gap was also variable across EU. In some countries, such as Portugal and Greece, there was little variation between MM and non-MM, both reporting harsh working conditions; the small gap was also observed in Sweden and Austria, but both groups reported favorable working conditions; and, finally, countries like Poland and France, experienced a great disparity in ER, with non-MM perceiving favorable working conditions, while MM workers reporting the opposite (Variation:PL=40%;FR=24%). In Europe, we found an association between MM and ERI (OR=1.42,95%IC1.21-1.65). However, this association was only significant in five out of sixteen EU countries.

CONCLUSIONS

: In Europe, multimorbid workers were more likely to report an imbalance in their working environment. Yet, this relationship was not consistent across countries, possibly following the high inter-country heterogeneity in working conditions. Future research should be devoted to understand which country characteristics cause working imbalance to be greater in people with MM.