Employees as a group are getting older and fewer. It is therefore particularly important to maintain the employability of those who are still working. This is particularly challenging for employees who experience health restrictions in their working lives. How many are affected in Germany?

Policymakers are constantly emphasising that people should "work healthily until they retire". But for most older employees, this remains a pipe dream. Working while ill, on the other hand, is a reality in companies - and increasingly so, because more and more older people are remaining in the labour force. Since 2011, we have been observing and surveying older employees in Germany on their path from working life to retirement with our lidA study (see also info box "The lidA study", editor's note). 62 per cent of them feel that their health is impaired by strenuous everyday activities. Only one in two describe their own general health as "good" or "very good".

Extrapolated, this means that seven of the 15 million employees aged between 50 and 64 are currently in employment even though their health is "not good". The economy also needs them in the labour force. The real challenge for companies is therefore not so much to ensure that people work healthily until they retire, but that they can work well and happily until they retire with their health restrictions.

Working with illness(es) is a broad field. What key challenges do you see and where do you tie in with your research in order to find answers - and solutions for practice?

The topic of "working with illness" is not as prominent in occupational health research in Germany as one might think. In the Netherlands, research in this area is much more advanced because employers there have to continue paying their employees' wages for twelve months in the event of illness. They therefore have a great interest in ensuring that employees are not absent due to illness - and if they are, that they return to work as quickly and sustainably as possible. So we have coordinated our research programme with our Dutch colleagues.

We have just published the latest results: almost all employees who receive company measures to promote health and fitness for work rate them as helpful. This is unexpectedly high and of course very pleasing. However, although two thirds of all older employees wanted such measures, only one in six received them. And it is precisely the groups that need them the most that receive them the least. It is important that we are able to substantiate this phenomenon with figures. From a prevention perspective, the crucial question now is: Why does this great need remain largely unmet despite the high perceived effectiveness? We want to investigate this in greater depth in the next wave of the lidA Study 2027.

To your knowledge, are there any important aspects of the topic that companies, employees or the environment are not really aware of?

"Working with illness" is still too hidden a reality. Many affected employees believe that they are alone with their health problems and have to deal with them themselves at work. This should not be the case! Our results show that a lot can be done to enable people with health restrictions to work well. If you don't want to go straight to your line manager or the disabled person's representative, you should contact the company doctor. They are bound by confidentiality and can make a big difference. Every company is obliged to have a company doctor.

Companies must be prepared for the fact that their employees also have health restrictions. On the one hand, we see that most older employees with health restrictions do their work well and do not have increased absenteeism. But some need help sooner or later to do their work well. Even small things can often help here, such as ergonomic adaptation of the workplace or more flexible working hours. But sometimes larger measures are also necessary. One success factor here is, of course, good management.

However, we have identified another factor, which we call the "corporate health culture". This means that the company attaches great importance to the health of its employees. If this is the case, people with health restrictions notice a significantly higher ability to work.

What can politicians do to keep people with health restrictions in employment in the long term?

Politicians need to realise that "working with illness" is the rule and not the exception in older working age. The trick is to enable people to work well and happily until retirement despite illness. I agree that health prevention is important throughout working life, but measures to promote the ability to work are at least as important. It is also essential that work is well organised and well set up. According to our calculations, around a third of all older employees work under poor working conditions overall!

Politicians and companies must also recognise that nowadays many older employees "bite through" to retirement despite poor health because they cannot afford to leave early. They often belong to occupational groups with heavy physical labour. Ways must be found to enable these people to retire in good time and with dignity.

The research findings to date show a pattern: so much good can be done here, but it is done far too rarely. But why is this the case? Labour science research in Germany must devote more attention to the topic of "working with illness". We need to help politicians and companies to make decisions not just based on gut instinct, but on scientific findings. There is a lot at stake here.