Health Promotion and Maintenance of Workability
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Professor md phd matti ylikoski reykjavik 9 11 2009

Health Promotion and Maintenance of Workability - National and Local Opportunities in Ensuring Employability of Aging Workforce -

Professor, MD, PhD. Matti Ylikoski

Reykjavik 9.11. 2009


Contents of the presentation

Contents of the presentation

  • The "why" of a National Strategy for "Promotion and Maintenance of Work Ability (PMWA)" – in Finland

  • The PMWA model, definitions and framework

  • PMWA in practice

  • Summary and conclusions

Prof. M Ylikoski, FIOH / 24.9.2014


Professor md phd matti ylikoski reykjavik 9 11 2009

  • The "why" of a National Strategy for "Promotion and Maintenance of Work Ability (PMWA)" – in Finland

Prof. M Ylikoski, FIOH / 24.9.2014


Professor md phd matti ylikoski reykjavik 9 11 2009

Population changes in Finland 1749 – 2008

Future demographic challenge was recognised

Emigration

Death- r

Immigrants

Birth – rate

Prof. M Ylikoski, FIOH / 24.9.2014


Professor md phd matti ylikoski reykjavik 9 11 2009

Finnish population by age groups 1865 – 2008

(Central Statistical Bureau, Fi)

Future shortage of young workers became critical

Prof. M Ylikoski, FIOH / 24.9.2014


Professor md phd matti ylikoski reykjavik 9 11 2009

Dependency Rate 1865 – 2050

Children and retired per 100 people at working age

Age

> 65 y

< 15 y

In 2008 in whole Finnish history the number of 65 years or older was higher than the number of those under 15 years old.

61 children; 10 retired

25 childern; 26 retired

28 children; 43 retired

Prof. M Ylikoski, FIOH / 24.9.2014


Important reasons for staying at work until statutory old age retirement statistics finland 2006

Important reasons for staying at work until statutory old-age retirement(Statistics Finland 2006)

Prof. M Ylikoski, FIOH / 24.9.2014


Professor md phd matti ylikoski reykjavik 9 11 2009

> 20 years follow–up research for the why of the strategy- a cohort of 7000 municipal employees since 1981 - (Tuomi ym. 2005; Ilmarinen 1996)

  • Workplace supports work ability and health (and the business), if:

    • well organised, open communication and collaboration

    • opportunities to develop and influence,

    • managing over- and underloading

    • managing conflicts and insecurity at work

  • Mismatch between man and work varies with age and work

  • Work ability varies widely between branches and trades

    • work should be adjusted with flexibility through the life course

    • new abilities are needed for info-jobs and new technologies

    • retired, temporary hindered and unemployed have work ability still

    • return to work (sick pay; rehabilitation) needs support

  • Problems to appear:

    • economic depression with restructurings

    • agriculture and forestry, pulp and paper- and metal industries, transportation, construction, social services

    • vulnerable groups: women, handicapped, youngsters, unemployed aso.

  •  Work ability was seen as the most important asset of employees

    in work life, where: health and functional capacity are basic

    explanatory variables which influence to – and depend on

    - other individual and work related factors,

    such as workplace as an organisation and community.

     A systemic approach was needed !

    Prof. M Ylikoski, FIOH / 24.9.2014


    Workplace health promotion as a model to maintain and promote work ability a systemic approach

    Workplace health promotion as a model to maintain and promote work ability - a systemic approach -

    • Health promotion are empowering activities which, aim:

      • to increase the opportunities and prerequisites of people in taking care of the health of them, their environment, in their community, and with the support of its social resources (WHO: Ottawa Charter 1986)

    • Workplace is ONE of the settings and "social arenas", which offer special opportunities to promote workers´ health an work ability:

      • as a community and a decision making system with resources for health and thus, for adjusting work for workers health, and

      • as an environment with particular exposures and thus, duties concerning to manage and combat against hazardous loadings.

    Prof. M Ylikoski, FIOH / 24.9.2014


    F rom handicap orientation via balance model towards a multifactorial approach

     From "handicap" orientation - via balance model - towards a multifactorial approach

    Individual with limited

    abilities in regard of job demands

    Individual in the work life context and "system"

    Individual with

    a handicap

    (Work) Life

    Organisation

    Job

    Individual

    (Work) Life

    Bio – Psycho – Social

    "residual" work ability

    Disability

    Medical invalidity

    Prof. M Ylikoski, FIOH / 24.9.2014


    Professor md phd matti ylikoski reykjavik 9 11 2009

    Widening of the "Well-being at Work" concept (Hämäläinen 2008, Hanson 2007, Ylikoski ym. 2006, Kickbusch 2004, Whitelaw ym. 2001)

    • From pathogenic approach towards "salutogenic" view

      • what is dangerous to health  what is good for health and well-being

        • health as a resource in meeting life (conditions/environment)

  • From prevention towards promotion

    • risk factors  health and work ability determinants

    • protect and avoid  strengthen, support

    • reactive  predictive (proactive)

      • unemployment research  coping with transitions at work life

  • From objects for expert actions towards participation of the empowered people

    • individual lifestyle  population & organisational (setting) partnership strategies with empowered actors

    • general models and Good Practices  locally tailored solutions

    • specialized campaigns  continuous strategic integration and processes with committed actors

  • (Re)integration of well-being and productivity

  • Prof. M Ylikoski, FIOH / 24.9.2014


    Professor md phd matti ylikoski reykjavik 9 11 2009

    2. The PMWA model, definitions and framework

    Prof. M Ylikoski, FIOH / 24.9.2014


    Work functional capacity and age are linked and there is lot to do ilmarinen 1999

    Work, functional capacity and age are linked- and there is lot to do -(Ilmarinen 1999)

    %

    Functional capacity & competence

    PROBLEM

    Promote and maintain work ability

    Reserve

    Reserve

    Job demands

    Decrease job demands

    Age

    SOLUTIONS

    Prof. M Ylikoski, FIOH / 24.9.2014


    Pmwa rationale

    PMWA: Rationale

    • PMWA operations were based on:

      • knowledge of aging,

      • physiological, psychosocial and health changes needing special emphasis due to aging of the work force and

      • knowledge for adjustment the work conditions according to the individual at his/her situation.

    • However, recently the whole life course and work career are considered as a challenge for the PMWA activities

      • qualifications needed at work are changing continuously

      • life course transitions challenge coping aptitudes regularly

      • organisational changes evoke individual support and adjustments

    Prof. M Ylikoski, FIOH / 24.9.2014


    Professor md phd matti ylikoski reykjavik 9 11 2009

    -

    transfer to

    decent job

    Supporting career through the whole life course

    (Vuori et al. 2007)

    40+ workers

    /

    Unemployed and

    kicked out

    Successful

    Senior

    Vocational

    training

    To Job

    • promotion of career

    • prevention of burn out

    re-employment

    From School

    to Work

    Basic training

    Towards

    Work life

    Pilot,

    to be published

    2009

    Prevention of mental depression

    -

    promotion

    Country

    wide since 1997

    of active

    learning career

    Published 2002

    country wide

    Published 2006,

    disseminating

    Prof. M Ylikoski, FIOH / 24.9.2014


    Definition of the pmwa

    Definition of the PMWA

    • Workplace activities aiming at promoting and maintaining the ability to work

      • include all measures,

      • that the employer and the employees as well as

      • the co-operative organizations at the workplace take in a united effort

      • to support the ability to work and to enhance the functional capacities of all persons active in working life

      • throughout their working careers

         Two-Partite Consensus with recommendation 1990

         Obligatory (employers duty) legislation 2001

    Prof. M Ylikoski, FIOH / 24.9.2014


    Professor md phd matti ylikoski reykjavik 9 11 2009

    3. PMWA in practice

    Prof. M Ylikoski, FIOH / 24.9.2014


    Professor md phd matti ylikoski reykjavik 9 11 2009

    Target areas and their "weight" in the PMWA measures

    (Ilmarinen 2006)

    Individual:

    Health and functional capacity

    Society

    Family

    PMWA

    activities

    Work and work environment:

    Work conditions

    Job content and demands

    Subjective:

    Values

    Attitudes and motivation

    Competence

    Professional and social

    Work community and organization

    Community and organization

    Management and leadership

    Participation

    Organizational learning

    Prof. M Ylikoski, FIOH / 24.9.2014


    Professor md phd matti ylikoski reykjavik 9 11 2009

    The organizational development axis in the PMWA

    "four flies with one hit"

    - how to act in practice ? -

    Individual

    PMWA

    activities

    Values and competence

    Work and work environment

    • Work community and organization

    • empowering  self – esteem  health

    • participation  commitment  achievements more concrete

    • co – construction  organizational learning  social capital

    Prof. M Ylikoski, FIOH / 24.9.2014


    Professor md phd matti ylikoski reykjavik 9 11 2009

    From practical experiences, research and corporative collaboration towards legislation, wide programmes and good practices

    Main activities in practice

    • PMWA in companies nationwide

      and obligated for employers (2001 -)

    • "Work Ability Index" for assessment (1998 - )

    • "Flexible retirement" – legislation (2005 -)

    • "Age Management" – training (1999 -)

    • "Transition coping" – model (1997 - )

    Practical experiences

    • Experts (OS&H)

    • Workers, managers, HR

    Good Practices:

    Experts (OS&H)

    Work places

    Nation wide

    Programmes

    • Ministries

    • Social partners

    • Soc Sec Insur Co´s

    • Regional networks

    • Companies

    • NGO´s

    Research

    • Long-term cohort

    • Surveys

    Legislation

    Social partners

    • Policies

    • Negotiations

    Social partners

    • Agreements

    • Recommendations

    1995 -

    1980 -

    1990 - 2001 – 2005 -

    Prof. M Ylikoski, FIOH / 24.9.2014


    Pmwa measures carried out training and competence building

    PMWA measures carried out:Training and competence building

    Prof. M Ylikoski, FIOH / 24.9.2014


    Pmwa in operation improvements in team function and organization

    PMWA in operation: Improvements in team function and organization

    Prof. M Ylikoski, FIOH / 24.9.2014


    Positive effects achieved

    Positive effects achieved

    Cooperation improved

    Work environment improved

    Physical fitness increased

    Motivation to work higher

    Prof. M Ylikoski, FIOH / 24.9.2014


    Professor md phd matti ylikoski reykjavik 9 11 2009

    The benefits of PMWA is equivalent to it's costs (employers 1999 & 2005)

    %

    70

    63

    62

    60

    50

    40

    28

    30

    21

    20

    10

    10

    6

    5

    3

    0

    0

    0

    Very good

    Fairly good

    Fairly bad

    Very bad

    Can't say

    (Work Ability Barometer 2005)

    Prof. M Ylikoski, FIOH / 24.9.2014


    Professor md phd matti ylikoski reykjavik 9 11 2009

    Expected effective retirement age for 50-year-olds

    Nordic countries in 1996–2007

    Prof. M Ylikoski, FIOH / 24.9.2014


    Professor md phd matti ylikoski reykjavik 9 11 2009

    Expected effective retirement age for 30-year-olds

    Nordic countries in 1996–2007

    Prof. M Ylikoski, FIOH / 24.9.2014


    Professor md phd matti ylikoski reykjavik 9 11 2009

    Expected effective retirement age for 30-year-olds

    Nordic countries 1996–2007, females

    Prof. M Ylikoski, FIOH / 24.9.2014


    Employment rates of the 55 in the eu 15 2005

    Employment rates of the 55+ in the EU-15, 2005

    Stockholm- target

    EU-15 average

    Source: Employment in Europe 2006

    Prof. M Ylikoski, FIOH / 24.9.2014


    Professor md phd matti ylikoski reykjavik 9 11 2009

    Finland: Increase in the employment rate of ageing workers has been most prominent in the EU during the latest 15 years (18 % - units !!)

    Employment rate

    Age group

    Statistics Finland 2006

    Prof. M Ylikoski, FIOH / 24.9.2014


    Pmwa activities in finland evaluative summary

    PMWA Activities in Finland- evaluative summary

    • Amount of PMWA quite high with many positive effects

    • Versatile content of PMWA

    • High confidence to economical benefits:

      • good cost and benefit ratio,

      • follow – up of the cost – efficiency has increased

    • The role of OHS significant

    • SMEs need more support

    Prof. M Ylikoski, FIOH / 24.9.2014


    Professor md phd matti ylikoski reykjavik 9 11 2009

    Thank You for Your Attention !

    Prof. M Ylikoski, FIOH / 24.9.2014


    Further readings

    Further readings

    • Ministry of Social Affairs and Health & Finnish Institute of Occupational Health (2004): Good occupational health practice. A guide for planning and follow - up of occupational health services. Ministry of Social Affairs and Health & Finnish Institute of Occupational Health. Helsinki. ISBN 951-802-566-5

    • Ilmarinen J. Towards a Longer Worklife ! Ageing and the quality of worklife in the European Union. Finnish Institute of Occupational Health, Helsinki 2005.

    • ILO: Tackling Global Crisis. Recovery through decent work policies. RepI(A) 2009

    • Vahtera J, Kivimäki M, Pentti J, Linna A, Virtanen M, Virtanen P, Ferrie JE.Organisational downsizing, sickness absence and mortality: the 10-Town prospective cohort study.British Medical Journal 2004; 328:555-557

    • Tuomi K, Ilmarinen J, Martikainen R et al.: Aging, work, life-style and work ability among Finnish municipal workers in 1981-1992. Scand J Work Environ Health 23 (1997): suppl 1, 58-65.

    • Vuori, J., Koivisto, P., Mutanen, P., Jokisaari, M., & Salmela-Aro, K. (2008). Towards Working Life: Effects of an intervention on mental health and transition to post-basic education. Journal of Vocational Behavior, 72, 67-80.

    • Ylikoski M, et al. Health in the World of Work: workplace health promotion as a tool for improving and extending work life. Helsinki, Finnish Institute of Occupational Health, 2006. (Reports of the Ministry of Social Affairs and Health 2006:62)

    • Ylikoski M, Rantanen, J: The development of modern work organisations: a challenge to occupational safety and health. In Wirtschaftverlag NW (Ed): The future of working conditions: Tb / Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, 102: 289-297, Bremerhaven, 2000.

    Prof. M Ylikoski, FIOH / 24.9.2014


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