Elderly, work and worker health in Brazil: an integrative review

Abstract

Objective

To discuss the relation between old age, work and the worker health in Brazil, from Brazilian scientific productions collected by means of an integrative review. Method and results: once defined a guiding question and search criteria, a research was conducted in databases of the Scientific Electronic Library Online (SCIELO), the Latin American and Caribbean Health Sciences Literature (LILACS) and the Digital Brazilian Library of Thesis and Dissertations (BDTD). From 341 productions found, 10 of them were selected, after verification of the inclusion and exclusion criteria for this review.

Conclusion

Besides the incipiency of studies which relate work, elderly and worker health, throughout this research it was identified the low effectiveness of the public policies in the scope of work rights to elderly people in Brazil, taking into account their health. Therefore, it is highlighted the need for developing future studies and discussions on these themes, in order to promote the formulation of complementary public policies for improvement of the presence in work of elderly people with the adoption of actions aiming at attention to health of elderly workers in Brazil.

Keywords
Aging; Health of the Elderly; Work; Occupation Health; Public Policies

Resumo

Objetivo

Discutir a relação entre a velhice, o trabalho e a saúde do trabalhador no Brasil, a partir de produções científicas brasileiras obtidas de uma revisão integrativa. Método e resultados: Definidos uma pergunta norteadora e critérios para a busca, realizou-se uma pesquisa nas bases de dados Scientific Electronic Library Online (SCIELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Biblioteca Digital Brasileira de Teses e Dissertações (BDTD). No total de 341 produções encontradas, 10 foram selecionadas após verificação dos critérios de inclusão e exclusão para esta revisão.

Conclusão

Além da incipiência em estudos que relacionem trabalho, idoso e saúde do trabalhador, foi identificada, através das pesquisas, a baixa efetividade das políticas públicas no âmbito do direito ao trabalho para os idosos no Brasil, levando em consideração sua saúde. Portanto, aponta-se a necessidade de desenvolvimento futuros estudos e discussões sobre esses temas, de modo a promover a criação de políticas públicas complementares de incentivo à participação ao trabalho da população idosa com a adoção de medidas de atenção à saúde do trabalhador idoso no Brasil.

Palavras-Chave:
Envelhecimento; Saúde do Idoso; Trabalho; Saúde do trabalhador; Políticas Públicas

Introduction

Population aging has been causing large socioeconomic changes around the world, including countries under development like Brazil¹. In this process of demographic transition, the insertion or continuity of elderly in the job market are issues that have been affecting economies worldwide². According to data from the National Survey per Sample of Domiciles (PNAD) of the Brazilian Institute of Geography and Statistics (IBGE)³, in 2018 the quantity of elderly people in the Brazilian labor market was around 7.2% of employed workers, which represented approximately 7.5 million elderly persons in the workforce. In the same year, the Brazilian Institute for Applied Economic Research (IPEA), through its Labor Market Report⁴, has shown an analysis of the period from 2013 up to 2018, when it was notable that elderly remained in the work market in Brazil, even in times of economic crisis.

Although elderly workers population still shows itself in a smaller proportion when compared to the population of young and adult (non-elderly) workers, since the third quarter of 2016, the proportion of the employed population over 60 years old is the one that has been growing the most. The ultimate data show an increase of 7.8% of employed persons in this age group between the second quarters of 2017 and 2018; meanwhile in the same period the youngest group, between 18 and 24 years old, decreased by 0.7%, the range from 25 to 39 years old remained stable and the one from 40 to 59 years old increased by 1.9%⁴.

The continuity of elderly Brazilians in work activities is associated not only with financial conditions, such as for example, a supplement for their retirement salary or an aid to their family income, but also to the need to remain active and sociable through work⁵. Work activity supports the creation of self-identity, which includes self-esteem and the sense of usefulness⁵. Additionally, in the current conjuncture of Brazil the permanence of the elderly at work is even more evident due to the new Brazilian public pension system, which considerably raises the minimum retirement age of workers⁶.

The theme in question is highlighted by the World Health Organization (WHO), on its 2015 World Report on Aging and Health⁷, which refers to the employability of the elderly as a way of contributing to active aging. Furthermore, in a book published by the IPEA in 2016, “National Policy for the Elderly: old and new issues”⁸, specifically in chapter 9, which deals with the relationship between the elderly and the job market, it is highlighted the importance of having healthy workplaces that favor the inclusion of the elderly free from discrimination.

In addition to the need to fit working spaces for elderly workers, considering their particularities, it is fact that we are facing a situation of intergenerational encounter between young and older people at the workplace⁹. Therefore, the importance of promoting the training and integration of the elderly is widely recognized. Besides these issues, the difficulty of dealing with the social representations that involve the universe of the elderly is evident, being strongly associated with the stigmas of unproductiveness and uselessness².

All these subjects demand studies in order to optimize and plan new social structures, which may give to elderly people a main role in this process, aiming at their physical and mental health. In this sense, an integrative review has been carried out with the objective to analyze and discuss Brazilian scientific productions published up to date, which deal with subjects like aging, work and health of elderly workers, in order to discuss the relationship between these themes and propose directions for future investigations.

Method

For this integrative review research, a study structure was adopted according to the following steps: 1) definition of the theme, formulation of a guiding question for the research and outline of descriptors; 2) definition of inclusion and exclusion criteria for reviewed productions; 3) search for productions (articles and academic studies) in databases, in order to answer the guiding question, following existing descriptors; 4) selection of the productions found, according to the established criteria; 5) analysis of the selected productions, to extract the data to be discussed; 6) discussion of results and conclusion of the work¹⁰.

Thus, based on the theme of the relationship between the growth of the elderly in the labor market and the worker health, for this study the following guiding question has been defined: How does the presence in the labor market influence the health of the elderly workers? From this question, Science and Health Descriptors (DeCs) in the Virtual Health Library (VHL) were searched, leading to identify the absence of terms such as “work of elderly” or “elderly workers”. Therefore, for the bibliographic research, other existing descriptors in the databases that most resembled the guiding question were used, namely: aging, work, elderly, worker health and labor market. From then on, using the Boolean operator “and”, combined searches between these descriptors from November to December 2020 were performed in the following databases: Latin American and Caribbean Literature in Health Sciences (LILACS), Scientific Eletronic Library Online (Scielo) and the Brazilian Digital Library of Theses and Dissertations (BDTD).

The search approach applied to the Scielo database was “aging” and “worker health. In the Lilacs database, the approach was “elderly” and “work”, being filtered by themes such as elderly, job market, aging and quality of life. Finally, in the BDTD database, “elderly” and “labor market” and “worker health” were the search approach used.

For the approach of final selection of productions, the following inclusion criteria were defined: a) on the theme of the Brazilian population aging, related to the permanence of the elderly in the labor market and the worker health; b) articles, theses and dissertations on the research theme; c) publications with full text available. As an exclusion criterion, duplicate productions or those addressed aging in a perspective beyond the theme of this review were discarded. For the organization and presentation of the search, the recommendations of the systematic model for reviews and meta-analyzes (PRISMA) were considered, as shown in Figure 1.

Figure 1
Prisma Flowchart - Result of data searches in Scielo, Lilacs and BDTD databases from November to December 2020.

Therefore, after the preliminary search in the databases applying the descriptors, a selection of titles and abstracts of articles, theses and dissertations was carried out, in order to choose the productions according to the research theme, following the pre-established criteria. After this filter of publications by titles and abstracts, the remaining ones were completely analyzed, to extract the necessary information for the discussion of this review. Finally, the collected information was submitted to a discussion, in order to relate the research theme to the content of this material for the formulation of conclusions.

Research results

At first a total of 244 articles in the Scielo and Lilacs databases were found, while in the BDTD database 97 publications were retrieved, thus totalizing 341 productions. Based on this search result, the established inclusion and exclusion criteria were applied and then 6 articles from the Scielo and Lilacs databases were selected at last. Respecting the same criteria, for the BDTD database, 1 PhD thesis and 3 master’s dissertations were finally chosen, after checking their abstracts (Figure 1). In order to organize the selected productions, the respective information was arranged in a table, in which the characteristics of each production are presented, such as the origin database, the title of the production, authors, journal, in addition to the respective proposals and themes. (Table 1).

Table 1
Results of searches in the Scielo, Lilacs and BDTD databases from November to December 2020.

Authors	Production title	Proposal and theme
Costa IP (2015)14	Quality of life of elderly in the context of work and their social representations	Study carried out with elderly people from a community group in Paraíba State. Data collection was conducted through interviews, using a sociodemographic questionnaire, the Free Word Association Test and the WHOQOL-BREF and WHOQOL-OLD. It aims to assess the quality of life (QoL) of elderly people who work and do not work and understand their social representations about QoL.
Santos NM (2016)15	Permanence of the elderly at work: structural and psychosocial factors	Investigation on factors that influence the permanence of elderly in work activities. The methodology was based on interviews, which were analyzed using a technique called Q-Sort and the software IramuteQ.
Sato, AT et al (2017)16.	The aging process and work: a case study in the maintenance engineering division of a public hospital in the city of São Paulo, Brazil.	The objective was to understand the relationship between aging and work.
Ribeiro P et al (2018)17.	Permanence in the labor market and life satisfaction in old age	Qualitative research, based on a database to verify the association of permanence in the labor market with sociodemographic, clinical and life satisfaction factors of elderly people. It was applied a questionnaire with semi-structured questions regarding the work activities carried out along life of elderly people.
Paolini KS (2016)18.	Challenges of elderly participation in the labor market	Literature and qualitative review research with the objective of evaluating the participation of the elderly in the labor market in Brazil and related public policies.
Gomes PS, Pamplona JB (2014)19	Population aging and its consequences on the labor market and public employment policies in Brazil	Bibliographic study that aimed to present and analyze the process of population aging in Brazil and its consequences on the labor market and the public employment policies.
Giaqueto A, Soares N (2010)20.	Work and the elderly worker	Remark on the labor world, showing that elderly people continue to experience the effects of social inequality.
Felix JS (2018)21.	Warriors above 60: Criticizing types of integration in the urban labor market for elderly people	It aims at understanding the employment conditions of the elderly workers, through a qualitative method with direct observation techniques and interviews based on a semi-structured questionnaire.
Sousa YG et al (2016)22.	Communication of occupational accidents on elderly through the epidemiological technical nexus	Characterization of benefits that NTEP (epidemiological technical nexus) provides to elderly workers in Brazil. It addresses the social protection for the elderly workers and the relevance for maintaining the quality of life of elderly people.
Antunes MH, Moré CLOO (2016)23.	Retirement, elderly health, and worker health: an integrative review of the Brazilian literature	Integrative review, with the objective of analyzing Brazilian scientific productions on retirement, elderly health and worker health.

For a wider discussion of the results, the texts of the following public policies, regarding to elderly people, were also consulted: Constitution of the Federative Republic of Brazil¹¹ of 1988, National Policy for Elderly¹² of 1994 and Statute of the Elderly¹³ of 2003. In addition as support for discussions, documents of the WHO⁷ and the IPEA⁸, on active aging and elderly in the labor market, are applied.

Discussion

Based on the search for productions, the starting point of the discussion on the proposed theme is the active aging, which is a current highlighted demand, considering the WHO recommendation in the World Report on Aging and Health⁷, which suggests in this sense the creation of inclusive environments for integration of elderly people, to promote sociability and quality of life.

On the matter of active aging, an exploratory and descriptive study¹⁴ evaluated a sample of 113 people over 50 years old. In this sample, it was identified that 44.2% of the inquired people were still working and 55.8% were no longer working. In the working group, 32% were elderly, aged from 60 to 64 years. In addition to these data, it was observed that the social representation of quality of life was mentioned in different ways. For the group of elderly workers, it was mainly related to the work activity and consumption possibilities, in addition to the maintenance of their own support. For the others, this representation was more associated with feelings and interactions in social groups. Finally, the maintenance of physical and mental health, better cognitive and social skills emerged in the analysis of the group in work activity, elderly or not.

A study by Santos¹⁵ investigated the factors that influence the continuity of the elderly in the labor market. From interviews with 121 elderly workers, four impact factors in this decision-making process were found, namely: the identity related to work, the social relationships built from it, family motivations and the necessity of income supplement. The interviewees brought to the debate the issue of work as a social basis and cited as concerning factors for workers the lack of planning to the retirement period and the lack of future perspectives.

The relationships between aging and work are presented in positive and negative ways in a case study with workers over 50 years old¹⁶. In the negative perspective, the analysis of the produced content addresses the reduction of mobility in carrying out activities, the lack of encouragement of employers to older workers in order to update their professional skills, in addition to the improper production structures for elderly. On the other hand, positive factors for these relationships are also listed, namely new challenges as a way to develop themselves as elderly, social connections established from work contexts, in addition to strengthening the well-being of these subjects.

Elderly participants in that research declared that their permanence in work activities, even with difficulties due to limited physical capacity, occurs by means of adoption of strategies to accomplish tasks. Among them, some have individual character, such as the continuous use of medications and/or auxiliary devices, and others are developed collectively, as compensatory attitudes and reorganization of work processes, with the aim of changing work activities. Therefore, the inquired elderly considered themselves able to work, even facing some health difficulties. It is important to mention that this study has a researched population of a specific sector, which may characterize a limitation of the analysis¹⁶.

In another study¹⁷ collected in the review, sociodemographic characteristics, such as income and education level, are treated as factors influencing the employability of elderly. It was identified that among elderly with a higher education profile, work backgrounds presented better job opportunities and health conditions. For this profile of workers, the motivation for work was mainly connected to personal satisfaction and income complement. In the group of workers with lower income and education conditions, continuity in work activity is related not only to supplementing family income, but also to less satisfaction with their activities. This condition was associated with a history of work with health wear. In addition, in terms of appreciation of the workforce, there is an indication that the younger workers have advantages over the depreciation of the older ones, due to the stigma of unproductivity associated with losses of motivation and physical capacity.

In Paolini¹⁸, intergenerational relationships in work environments are addressed, mentioning prejudice, stigma and competitiveness as affecting factors to the health of elderly workers. At the same time, factors favorable to the valuation of such workers are identified, such as incentives and opportunities for qualification and the adequacy of the labor market. Therefore, the importance of the employability of elderly, their requalification and their professional reinvention are highlighted.

Regarding the reduction of the physical capacity and health of elderly workers, Gomes and Pamplona¹⁹ report the relationship between old age and inequalities in access to health, education, income, dwelling and work activities carried out throughout life. Such relationships influence different perspectives of old age and work abilities of elderly people. This study highlights the importance of the reorganization of the State, in the construction of public policies for elderly, in a composition that respects the heterogeneity of aging.

When considering the relationship between the difficulties of insertion of elderly in work, the qualification and the productivity rhythms, other studies²⁰-²² emphasize the need for accomplishment of rights to professionalization, social participation and non-discrimination for elderly, already supported by Brazilian public policies¹¹,¹³.

According to the perspective of the researches by Giaqueto and Soares²⁰ and Félix²¹, changes in the labor world and the types of activities and opportunities for elderly are objects of considerations about the economic and social conditions for elderly workers and the consequences on causing different old ages. In this sense, work activities may represent a source of production of knowledge, skills, subsistence, but at the same time appear as a way of suffering, due to the forms of labor exploitation, being life expectancy treated as an additional challenge for ensuring the quality of life for this population.

For Félix²¹ limitations provided by society for elderly population are associated with the lack of ensured access to rights for elderly people, in which work is included. In his research, an overview of existing public policies is shown, such as the Brazilian Federal Constitution¹¹ of 1988, which supports the participation of the elderly in social means and free from discrimination and mentions that it is up to the family, society and the State to ensure and support them with guarantees to dignity and the right to life. In addition, article 26 of the Statute for the Elderly (EI) is referenced¹³, whose emphasis is to ensure the participation of the elderly in work environments, adapted to psychic, intellectual and physical conditions. This is reinforced by article 28 of the same document, which mentions the state’s responsibility to encourage companies to hire older people. In addition, social appreciation and integration between generations in the workplace or in the community is considered an important factor contributing to active aging²¹.

Sousa et al.²² addressed the issue of social security benefits, highlighting that a considerable portion of the population that receives benefits for accidents at work is within the age group between 60 and 84 years. In addition, it was identified in the same study, that these absences from work are related to an increase in physical and emotional suffering, emphasizing the vulnerabilities of elderly workers. In the same analysis, the need for work environments that promote health is mentioned, mainly due to the fact that Brazil is a country, whose elderly population tends to be increasingly active at work, especially in a precarious form, since most of them have low income²².

Although the right to work for elderly is established in public policies, it is observed that the adequate condition for this activity is rarely addressed in studies in the field of aging and health. Considering the labor market research of IPEA⁴, which shows a growing perspective of the participation of the elderly in informality, it is necessary to think about this matter, since workers in this condition do not have many rights recognized in practice. In this sense, it should be emphasized that the combination of work history and inadequate conditions for work leads to risks of illness and, consequently, to leave the labor market.

Finally, it is worth mentioning that the results found in the bibliographic search carried out for this review suggest that Brazilian scientific productions are still incipient in considering the relationship between aging, work and worker health. As for the methodological characteristics of the productions, there is a prevalence of qualitative studies over quantitative ones. As methodological tools, these productions used semi-structured interviews with scripts, review studies and direct observation techniques, in addition to softwares for data analysis.

The absence of specific descriptors in the researched databases, leading to the adoption in the search of alternative already existing descriptors, may be a limitation for the study of this thematic. For example, in an integrative review study²³, which addresses the relationship between elderly health, worker health and retirement, a total of twenty articles were found for analysis, based on specific search criteria. Only three of these articles were selected containing the themes of worker health and elderly health. However, a limitation in this analysis is observed, since among these publications, only one actually reports the issue of elderly’s work and its implications for worker health. Therefore, it can be questioned whether Brazilian publications in this area have excluded, to a certain extent, the dialogue with health, preferring other aspects.

Conclusions

Given the social changes resulting from larger longevity, in this integrative review of Brazilian publications in databases the relationship between old age, work and worker health was discussed, showing it as a new challenge to the State in the formulation or complementation of public policies for elderly in Brazil. Along with these policies, it is important that incentives for public and private institutions to enable participation and maintenance of workplaces for elderly workers may be created. This aims to support that elderly people may achieve better-suited income and well-being focused to their necessities, in addition to contribute to the inclusion of this group in the different spheres of the society.

Concern about the future of elderly workers in Brazil is emphasized and the challenges are great in this field. Studies on this matter are suggested by the results of this review, and should consider not only the participation of elderly in the labor market, but also the understanding of the types of illnesses arising from work, age groups and professions most affected by them and the work categories that most hire elderly.

Since aging of the workers follows that of the entire population, this condition is certainly experienced by other countries, even on a more advanced stage of aging. Thus, research for international works on this same theme is finally recommended, in order to contribute to the Brazilian scenario in this field. These suggested studies may in the future support the creation and establishment of specific public policies, complementing the current ones, aimed at the health of elderly Brazilian workers.

• No funding was received in relation to the present study.

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Edited by

Edited by: Ana Carolina Lima Cavaletti

Publication Dates

• Publication in this collection
  03 May 2021
• Date of issue
  2020

History

• Received
  01 July 2020
• Accepted
  30 Dec 2020