Trajectories of sustainable working life in nine Swedish residential regions: A longitudinal twin cohort study

OBJECTIVE: To investigate trajectories of sustainable working life (SWL, ie, no interruptions or transitions in working life due to sickness absence (SA), disability pension (DP), or unemployment) in Swedish residential regions using a population‐based twin cohort, while assessing sociodemographics and twin pair similarity. METHODS: Sample of 60 998 twins born in 1925–1958. SWL was assessed through main labor market status in each year in 1998–2016 based on > 180 days with SA/DP, > 180 days with unemployment, or >half of yearly income from old‐age pension for not in SWL, and employment (in paid work and did not fulfill the criteria SA/DP, unemployment, or old‐age pension) for SWL. Residential regions were classified into nine groups based on Swedish municipalities. Group‐based trajectory models and multinomial logistic regression were applied separately for all regions. RESULTS: In all regions, the largest trajectory group was sustainable working life. Three to four trajectory groups developed toward unsustainable working life with different exit points from sustainable working life. A small proportion were grouped with partial stable or increase in sustainable working life. Increased age, being a woman, <12 years of education, and history of unstable working life increased, and being married and twin pair similarity decreased the likelihood of belonging to trajectories toward unsustainable working life. CONCLUSIONS: In all regions, most of the individuals followed a sustainable working life trajectory. A reasonable proportion of individuals followed trajectories developing toward unsustainable working life. The influence of sociodemographic and familial factors on trajectory groups was similar in all regions.