Employment and Occupation Effects on Depressive
Symptoms in Older Americans: Does Working
Past Age 65 Protect Against Depression?
THE effects of work status on mental health outcomes may be viewed from a life course and role theory perspective.Work status may be considered a role that is central to onersquo;s identity, and one that also provides contextual benefits such as economic resources, social integration, and personal control. Retirement has been associated with a lower sense of control (Drentea, 2002). For a U.S. sample, loss of perceived control and physical dysfunction contributed to higher rates of depression in older individuals compared to younger adults (Mirowsky amp; Ross, 1992). Loss of work status under this perspective would likely result in a decline in mental health. However, exiting from the role of worker may reduce stress and role overload for individuals of normative retirement age, thus reducing rates of depression.
Employment is one of the primary roles in life course theory and is an important factor for depression. Mirowsky and Ross(1992) found that employment status along with marital status accounts for a large proportion of the changes in depression across age for adults. In this study, two major role statuses (market and familial) along with income removed a trend of increasing depression for those around 60 years old or older. Persons who were unemployed, part-time workers, housekeepers, and retired individuals showed higher levels of depression relative to full-time workers (Mirowsky amp; Ross, 1992). Also, Butterworth and colleagues (2006) found that men of retirement age have higher levels of depression when they are not working for pay compared to those of retirement age who do work for pay.
Whether the role of worker has a deleterious or beneficial impact on an individual depends in part on what is normative for that individual in terms of the life course as well as the overall context of the role. For example, job characteristics such as stress, prestige, and control may make a marked difference in the effects of work status on depressive symptoms. Several studies have revealed that depressive symptoms are more prevalent among workers with job stress(Mausner-Dorsch amp; Eaton, 2000; Wang, 2005), low-skill work(Sanne, Mykletun, Dahl, Moen, amp; Tell, 2003), and lower job status (Link, Lennon, amp; Dohrenwend, 1993). Other analyses have found that workers in particular occupations have higher levels of morbidity (Lee et al., 2006) and depression (Sanne etal., 2003).
The context of work matters for mental health outcomes among individuals of traditional retirement age. Recent research has shown sharp declines in depression and anxiety around the traditional age of retirement for men and women(Villamil, Huppert, amp; Melzer, 2006). However, Villamil and colleagues found the drop in depression at this age was not attributable to work status and that, in fact, working was associated with better mental health for men aged 45 to 74 after controlling on social class, job loss in the past 6 months, and physical illness and limitation. Mein, Martikainen, Hemingway, Stansfeld, and Marmot (2003) reported mental health benefits of retirement for workers who were employed in higher socioeconomic status employment, whereas those currently or previously employed in lower socioeconomic status occupations did not improve their mental health upon retirement.
Changes in depressive symptoms at retirement likely depend on the specific circumstances of retirement. Szinovacz and Davey (2004) found that workers whose retirement was abrupt, too early, or forced experienced an increase in depressive symptoms, whereas those who retired lsquo;lsquo;on timersquo;rsquo; and willingly did not differ in their levels of depressive symptoms as compared to nonretired workers. This finding implies that unexpected work role changes can have deleterious effects on mental health. The working retired also did not differ from the working nonretired, indicating that perhaps those working in lsquo;lsquo;bridge jobsrsquo;rsquo; did not differ from those working in their preretirement jobs. Szinovacz and Davey did not find that these relationships differed after controlling for household income and changes in net worth during the retirement transition.
In sum, many studies have found working to be associated with better mental health among older individuals, particularly men. However, findings are not consistent, and other contextual factors (such as socioeconomic status, job characteristics, and the circumstances of work status changes) are important factors for the association between work and depression.
Depression in later life is often comorbid with physical illness (Blazer, 2003). Physical illness also affects onersquo;s ability to work. Therefore, an analysis of the mental health risks and benefits of workers is often hindered by a selection effect coined the healthy worker effect, whereby individualsrsquo; poor physical health may both prevent them from working and cause increased levels of depression. This selection effect may be especially important for analyses of older populations with a higher incidence of physical limitations. Nearly all of the studies referenced here included controls for physical health in longitudinal models.
In this article, we test the effect of work status on depressive symptoms in a high-quality, representative sample of Americans aged 65 and older. We consider occupational sector and occupation type as a potential contextual factor that may explain some differences in levels of depressive symptoms between older workers and nonworkers. Because occupations have different levels of integration, prestige, income, stress, autonomy, and so on, we expected them to differentially affect mental health. We hypothesized that working would provide a mental health benefit for workers employed in occupational sectors and types that have higher prestige due
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附录C 中文译文
就业和职业对美国老年人的抑郁症的影响：
工作超过65岁能预防抑郁症吗？
心理健康状况对工作地位的影响可以从一个生命历程和角色理论视角来分析。工作地位可能被看做是一种个人中心身份和提供例如经济资源，社会融合和个人控制的好处的角色。退休与弱控制感有关。举一个美国的样本，相对于成年人，老年人在感知控制下降和物理障碍下产生抑郁的几率更高。在这方面工作地位的下降有可能导致心理健康问题。然而，工人角色和到达规范的退休年龄的个人的角色过载的兴奋感可以减少压力，从而减低抑郁几率。
就业是人生课程中基础角色之一，而且是抑郁的一个重要因素。米乐思和罗斯发现就业地位和婚姻状况在成年人不同年龄阶段对改善抑郁占很大比重。在这个研究中，两个主要角色状态（市场和家庭）和收入对那些60岁或以上的老年人能够减缓抑郁上升的趋势。无业的人，兼职工作者，家庭主妇和退休者相对于专职工作者表现出更高程度的抑郁。此外，巴特沃斯和他的同事（2006）发现不继续工作赚取的退休者相对于那些退休了继续为获得收入工作有更高程度的抑郁。
无论工作者的角色对个人产生不利或有益的影响部分取决于在人生历程和整体环境作用方面对个人来说什么是规范的。举例来说，诸如压力，声望和权威这些工作特性在工作地位对抑郁症的影响上可以产生显著性的差异。几项研究呈现了抑郁症在工作者有工作压力，从事低技能工作和低工作地位中更普遍。其他分析者发现工人尤其是职工更有高程度的发病率和抑郁。
在传统退休年龄退休的个人的精神健康结果与工作环境有关。近期的研究表明在传统退休年龄退休的男女的抑郁和焦虑急剧下降。但是，弗勒米和他的同事发现这个年龄抑郁的下降不是因为工作状态，事实上，工作对经历过社会阶层控制，六个月前的失业和生理疾病与限制的45到74岁的男性来说，与良好的心理健康有关。梅，马特凯恩，海明威，斯坦斯菲尔德和马默特报告了曾就业于更高社会经济地位的工作者的心理健康在退休时受益，而那些现在或之前受雇于低社会经济地位职业的工作者没有在退休时改善他们的心理健康。
退休的抑郁症状的变化可能取决于退休的具体情况。西诺瓦和大卫(2004) 发现那些突然的,太早的,或被迫退休的退休工人会增加抑郁症状程度,而那些“准时”退休的,心甘情愿退休的退休工人在抑郁症状水平上和未退休工人相比没有什么差异。这一发现意味着不可预期的工作角色的变化可以对心理健康产生有害的影响。退休后返聘工作也并没有不同于未退休的工作,表明也许那些正处在各自工作中的人并没有不同于那些提前退休工作的人。西诺瓦和大卫没有发现这些关系控制了不同家庭的收入和退休过渡期间净资产的变化。
总之,许多研究发现在老年人尤其是男人中，工作与更好的心理健康紧密联系。然而,研究结果是不一致的,工作与抑郁症之间的其他相关因素(如社会经济地位、工作特点和工作状态变化的情况下)也是十分重要的。
抑郁症在今后的生活中通常与身体疾病伴发(布莱泽, 2003)。身体疾病也会影响一个人的工作能力。因此，工人的心理健康风险和收益分析往往受到创造了工人的健康效应的选择效应的阻碍，即个人的身体健康不佳可能影响他们的工作和事业并增加他们的抑郁程度。这可能对于分析老年人口发病率高的物理限制有特别重要的选择影响。几乎所有引用在这里的研究都包括在纵向模型中的身体健康控制。
在本文中,我们测试抑郁症对于一个高质量的,具有代表性的65岁及以上的美国人的工作状态的影响。我们认为职业领域和职业类型作为一个潜在的语境因素可以解释一些年长员工和非工作人员的抑郁症状水平差异。因为职业有不同层次的集成，如声望、收入、压力、自主权,等等,这些与我们的期望的差异影响了我们的心理健康。我们猜测由于金融和上下文相关的这些工作的好处在有较高的威望的职业领域和类型工作有利于工人的心理健康。
附录D 外文原文
Employment and Occupation Effects on Depressive
Symptoms in Older Americans: Does Working
Past Age 65 Protect Against Depression?
THE effects of work status on mental health outcomes may be viewed from a life course and role theory perspective.Work status may be considered a role that is central to onersquo;s identity, and one that also provides contextual benefits such as economic resources, social integration, and personal control. Retirement has been associated with a lower sense of control (Drentea, 2002). For a U.S. sample, loss of perceived control and physical dysfunction contributed to higher rates of depression in older individuals compared to younger adults (Mirowsky amp; Ross, 1992). Loss of work status under this perspective would likely result in a decline in mental health. However, exiting from the role of worker may reduce stress and role overload for individuals of normative retirement age, thus reducing rates of depression.
Employment is one of the primary roles in life course theory and is an important factor for depression. Mirowsky and Ross(1992) found that employment status along with marital status accounts for a large proportion of the changes in depression across age for adults. In this study, two major role statuses (market and familial) along with income removed a trend of increasing depression for those around 60 years old or older. Persons who were unemployed, part-time workers, housekeepers, and retired individuals showed higher levels of depression relative to full-time workers (Mirowsky amp; Ross, 1992). Also, Butterworth and colleagues (2006) found that men of retirement age have higher levels of depression when they are not working for pay compared to those of retirement age who do work for pay.
Whether the role of worker has a deleterious or beneficial impact on an individual depends in part on what is normative for that individual in terms of the life course as well as the overall context of the role. For example, job characteristics such as stress, prestige, and control may make a marked difference in the effects of work status on depressive symptoms. Several studies have revealed that depressive symptoms are more prevalent among workers with job stress(Mausner-Dorsch amp; Eaton, 2000; Wang, 2005), low-skill work(Sanne, Mykletun, Dahl, Moen, amp; Tell, 2003), and lower job status (Link, Lennon, amp; Dohrenwend, 1993). Other analyses have found that workers in particular occupations have higher levels of morbidity (Lee et al., 2006) and depression (Sanne etal., 2003).
The context of work matters for mental health outcomes among individuals of traditional retirement age. Recent research has shown sharp declines in depression and anxiety around the traditional age of retirement for men and women(Villamil, Huppert, amp; Melzer, 2006). However, Villamil and colleagues found the drop in depression at this age was not attributable to work status and that, in fact, working was associated with better mental health for men aged 45 to 74 after controlling on social class, job loss in the past 6 months, and physical illness and limitation. Mein, Martikainen, Hemingway, Stansfeld, and Marmot (2003) reported mental health benefits of retirement for workers who were employed in higher socioeconomic status employment, whereas those currently or previously employed in lower socioeconomic status occupations did not improve their mental health upon retirement.
Changes in depressive symptoms at retirement likely depend on the specific circumstances of retirement. Szinovacz and Davey (2004) found that workers whose retirement was abrupt, too early, or forced experienced an increase in depressive symptoms, whereas those who retired lsquo;lsquo;on timersquo;rsquo; and willingly did not differ in their levels of depressive symptoms as compared to nonretired workers. This finding implies that unexpected work role changes can have deleterious effects on mental health. The working retired also did not differ from the working nonretired, indicating that perhaps those working in lsquo;lsquo;bridge jobsrsquo;rsquo; did not differ from those working in their preretirement jobs. Szinovacz and Davey did not find that these re
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