Welcome to Work Life, a blog about the relationship between work and health and well-being of people, whether they are preparing for working life, managing their work / life balance or preparing for retirement and life beyond retirement.
What are the influences on our employment prospects across our working lives? Could where we live when we’re young be important when we’re older – regardless of our social class or level of education? A new study by Emily Murray and colleagues from UCL, King’s College, London and Queen Mary, University of London, finds if we live in an area of high unemployment when we’re young, we’re more likely to leave the labour market at a younger age.
Which factors can help improve our prospects of employment – and of good health – in mid-life? One reason the question is important is that if we can stay healthy longer and work longer, we are less dependent on the state. And the cost of our ageing society is a major issue for governments and individuals across the developed world.
In the UK the state pension age will be raised to age 67 by 2028, but in fact most employees leave work well before they reach that stage. For some that’s a positive thing, but for others it’s forced upon them by unemployment or poor health – and that contributes to social inequality among older people.
Who is at risk? We know older workers in areas of high unemployment are more likely to be on disability benefits. And older people are more likely to leave work for non-health reasons, too – if they are made redundant, they find it harder than their younger colleagues to find another job.
But until now we didn’t know much about how unemployment and other factors experienced by the young might affect their prospects of being in work as they approach the state retirement age.
There are good reasons to suspect there might be an effect –research has shown that periods of unemployment in young adulthood can have a ‘scarring’ effect – so it stands to reason that early work experiences could set some people on good trajectories and others on less positive ones.
Higher-level job opportunities aren’t evenly distributed, and so we might speculate, for example, that workers in the north – where access to careers in finance, for instance, would be poorer than in the south – would be less likely to start out on one of those ‘good’ pathways.
And education might make a difference, too. We know those growing up in poorer areas are likely to end up with fewer qualifications, and therefore to be disadvantaged in the jobs market. That, too, could continue to affect them throughout their lives.
So health, employment status, occupational class and education might all influence the length of our working lives and lead to unequal retirement outcomes.
Survey of health and development
We used the Medical Research Council National Survey of Health and Development (NSHD), a sample of all births in one week in March 1946 across England, Scotland, and Wales, to test our theories.
This group of people have been questioned 24 times throughout their lives, most recently in 2014 when they were aged 68. We used data from when they were aged four, 26, 53, 60-64 and 68 – a total sample of 2526 people, all of whom had given information on their retirement age or were still in work at age 68 years.
We found there was a correlation between increased unemployment rates in the area a person lived in mid-life and the likelihood of an individual retiring earlier. However, this relationship was explained by where people lived earlier in life.
For example, cohort members who lived in an area with higher unemployment when they were 26 were more likely to be outside the labour market at age 53. Compared to those who worked full-time, those who were unemployed at aged 53 retired on average 4.7 years earlier.
Similarly, mid-life health problems were more common among those who had lived in areas with high unemployment at age 26, even when taking account of age 26 health status.
We did not find a direct link between educational achievement by age 26 and retirement age. We did, however, find indirect links: for example, those who did not obtain any educational qualifications by age 26 were more likely to live in areas of high unemployment than those who gained degrees. There was no association between area unemployment at age 4 and educational achievement at age 26.
Adulthood is key
Our findings show for the first time that early adulthood is a key life stage at which local labour market conditions can affect our eventual retirement age. We found this happened through two interlinked factors – high area unemployment and worse health status at age 26.
So, there are clear messages for governments: strategies to extend the working lives of future generations will be most effective if they address youth unemployment rather than focusing on older workers in areas with high unemployment.
Policies to extend working life should focus not just on individuals but also on the wider labour market context in which those individuals reside. Maintaining employment and good health in mid-life are key to ensuring that individuals can work longer. And large-scale interventions that create new jobs in areas with high youth unemployment could bring long-term positive consequences for future generations’ extended working lives.
Linking local labour market conditions across the life course to retirement age: Pathways of health, employment status, occupational class and educational achievement, using 60 years of the 1946 British Birth Cohort, is published in Social Science & Medicine.
Emily T. Murray, Paola Zaninotto, Maria Fleischmann, Nicola Shelton and Jenny Head are based at the University College London Department of Epidemiology and Public Health.
Mai Stafford and Diana Kuh were based at the Medical Research Council Unit for Lifelong Health and Ageing at University College London when this paper was written.
Ewan Carr is also based at the Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London
Stephen Stansfield is based at the Queen Mary University of London, Wolfson Institute of Preventive Medicine, Centre for Psychiatry.
Across the globe, more people are spending more time in retirement than ever before. So staying healthy in later life is critical. Yet political debates on ageing tend to ignore a growing body of research on how retirement can affect our health. Baowen Xue and colleagues from the Department of Epidemiology and Public Health at UCL looked at links between retirement and cardio-vascular disease – and found unexplained differences between Europe and the US.
Is retirement good for your heart, or bad for it? The question is an important one because cardio-vascular disease (CVD) is the biggest cause of death globally and costs health services a huge amount of money.
Some studies have shown retired people have a higher risk of being diagnosed with CVD than those who are still working. But until now the evidence has been unclear.
We set out to review evidence from across the world, so that we could help to build a more accurate picture of whether, and how, retirement might affect our cardio-vascular health. As CVD is linked to our lifestyle, diet and other behaviour, there are lots of ways in which changes that take place in retirement might have an effect – both negative or positive.
We looked for longitudinal studies that could help answer our questions, and found 82 which measured risk factors for CVD and 14 which looked at actual incidence of CVD. The second set of 14 papers provided the answer to our first question – does retirement affect our cardio-vascular health?
The answer revealed a major difference between the USA and Europe. Studies conducted in the US showed no significant effect, good or bad, on retirees’ cardio-vascular health. In Europe, meanwhile – with the exception of France – studies consistently showed a link between retirement and an increase in CVD.
Data from the British Regional Heart Study, for instance, showed that healthy men who retired before the age of 60 were more likely than others to die from circulatory disease within five and a half years. Fatal and non-fatal CVD was also more common among retirees in Denmark, Greece, Italy and the Netherlands.
Why might this be? Could there be cultural or lifestyle differences between Europe and the US which might cause this difference? We took a systematic look at the risk factors.
First, we looked at weight gain. If Americans were less likely to put on weight after retirement compared to Europeans, that might help to explain the difference. But when we looked at this, we found that body mass index (BMI) actually increased after retirement in the USA – and also Japan -but did not change in England, Denmark, France, Germany, Switzerland or Korea. While those who do physically demanding jobs are likely to put on weight after they retire, most people aren’t.
Could it be that retired people generally do less exercise – another risk factor – in Europe? The studies suggest that’s not the reason. While many retirees did more physical activities, they also spent more time sitting still – so the effect was a balanced one. For instance, a retiree might play more golf, but also watch more television.
Do retired people perhaps smoke more, we asked? Again, there were contradictory results but 12 out of 14 studies either showed no effect or showed retirement led to people smoking less.
Perhaps retired people in Europe drink more, then? Again, this couldn’t be identified as the reason. Studies in Australia, the UK, Japan and the USA suggested there was no association between retirement and alcohol consumption.
Diet is another possible cause of CVD, but again, there was no clear pattern of between retirement and diet emerged from reviewed studies.
So the picture isn’t straightforward, and we don’t have answers as to why retirement might put Europeans at risk but not Americans. What we can say, though, is that none of the studies we looked at found any beneficial effects of retirement on CVD.
Apart from a decrease in smoking, there wasn’t evidence of any general ‘relief’ effect of retirement on people’s cardio-vascular health – so the supposition that working could be bad for our health and therefore retirement better for it doesn’t necessarily hold true.
However, studies that showed retirement brought negative health effects should be interpreted with caution. Many assessed the health effects of retirement by comparing retired people with employed people – and we know people who stay in the labour market are generally healthier than retirees. We do know people who have CVD, diabetes or hypertension are more likely to retire.
What our review has done is to reveal the complex nature of the underlying mechanism through which retirement might impact on the risk factors for CVD. Different people react differently to retirement, depending on their life experiences and the cultural and policy environments in which they live. So there isn’t one global solution to any of this – each country needs to plan its citizens’ retirement according to their individual needs.
Flexible working is considered good practice – and in England, most workers have the right to apply to work flexibly after they’ve been in their job six months. But what do we know about the benefits? A new study by Tarani Chandola and colleagues used biological measures to look at differences in stress markers among workers with reduced hours and those without.
In recent years many employees have been able to alter their work patterns to fit in with childcare and other responsibilities. Typically, this can mean working part-time, job-sharing, only working during school term-times or working from home some of the time.
It’s assumed this should help to relieve stress. But until now, we didn’t know whether this was necessarily the case. After all, there could be down-sides – for example working at home can mean a blurring of the boundaries between work and family time, part-time working can be a barrier to promotion and job-sharing can bring its own tensions.
Until recently we had to rely on workers’ own reports of how they felt in order to judge this interplay between work, family life and stress. But now a number of social surveys have begun collecting samples which allow us to measure biological changes which can indicate stress, too.
This is known as ‘allostatic load’ – when we’re repeatedly subjected to stress or trauma, this can lead to chronically heightened levels of stress hormones. And that is associated with all sorts of long-term health problems, such as heart disease, type-2 diabetes and depression.
We were able to use data from participants in the Understanding Society study, which began in 2009 and which follows more than 60,000 adults in 40,000 households. As well as responding to detailed questionnaires, many of them have been visited by nurses who have taken physical measurements and blood samples.
As well as blood-based markers such as insulin growth factor 1 and cholesterol, their pulse rate, blood pressure and waist-to height ratio were also measured.
After taking out those who weren’t employed, who didn’t have the nurse visits or for whom some measurements were missing, we had a sample of a little over 6,000 people.
All those people had been asked whether flexible working arrangements were available at their workplace, how many hours they worked and whether they were the primary carer for their children.
We categorised working hours into three groups, with different levels for men and women because they tend to have very different working patterns. So women were grouped into those working less than 24 hours per week, more than 25 hours and more than 37 hours; while men were grouped into those working less than 37 hours, 37-40 hours and more than 40 hours.
Unsurprisingly, we found more women than men had made use of flexible working arrangements – almost no men in our sample were the main carers for two or more children.
There were particularly high levels of biological chronic stress markers among women with childcare responsibilities who worked more than 37 hours per week. Those with similar childcare responsibilities but working fewer than 25 hours per week didn’t have any measurable effect on their stress levels.
Both men and women who had access to, and made use of, reduced-hours flexible working had lower levels of biological stress markers than those who didn’t have flexible working.
We found these types of reduced-hours arrangement were more common among those in lower-paid occupations, especially among men, and among older workers of both genders.
Other types of flexible working arrangements, such as working from home, were more common among those from more advantaged social groups. But we didn’t find any association between these types of working and lowered levels of stress.
So, what has our study told us? We’ve learned a good deal about the complex relationships between social and biological factors in our lives. And, crucially for policymakers, we can see that it’s particularly important for women with childcare responsibilities to be able to access shorter working hours when they need to. For employers, this isn’t just a matter of logistics and of ensuring a stable and happy workforce – it’s also a major factor in ensuring that workers live longer and healthier lives.
The rise of globalisation and the 24/7 economy are fuelling demands for people to work long hours and weekends. But what’s the evidence about how these ways of working link with depression? Gill Weston and colleagues from the International Centre for Lifecourse Studies in Society and Health at UCL and Queen Mary University of London found such working conditions are linked to poorer mental health in women.
Across the globe, the effects of overwork are becoming apparent. In eastern Asian countries the risk of death due to overwork has increased. In the UK, work-related stress accounts for millions of lost working days every year.
Within the EU, a significant proportion of people have to work unsociable hours – with nearly a quarter working most Saturdays and a third working at least one Sunday a month. But despite this, there isn’t much clear evidence about the links between work patterns and mental health.
Some studies have found a connection between unsociable work patterns and depression. But many of the studies only focused on men, some only looked at specific types of worker or workplaces and few took account of work conditions such as whether workers had any control over how fast they worked.
To address these gaps, we set out to look for links between long or irregular hours and depression using a large nationally representative sample of working men and women in the UK. We particularly wanted to look at whether there were differences between men and women because research has shown that work is organised, experienced and rewarded differently for men and women, and because men and women react differently to overwork and time pressure.
We used data from Understanding Society, which surveys people living in 40,000 households across the UK. In particular we focused on information about working hours, weekend working and working conditions collected from 11,215 working men and 12,188 working women between 2010 and 2012. They had completed a questionnaire designed to study levels of psychological distress.
Who works the most?
We found men tended to work longer hours in paid work than women, and having children affected men’s and women’s work patterns in different ways: while mothers tended to work fewer hours than women without children, fathers tended to work more hours than men without children.
Two thirds of all men worked weekends, compared with half of all women. Those who worked all or most weekends were more likely to be in low skilled work and to be less satisfied with their job and their earnings than those who only worked Monday to Friday or some weekends
Which workers have the most depressive symptoms?
Women in general are more likely to be depressed than men, and this was no different in our study.
Independent of their working patterns, we also found that workers with the most depressive symptoms were older, smokers, on lower incomes, in physically demanding jobs, and who were dissatisfied at work.
Arelong and irregular hourslinked to depression?
Taking these findings and other factors into account, when we looked at the mental health effects of work patterns on men and on women, the results were striking: while there was little or no difference in depressive symptoms between men who worked long hours and those who did not, this was not the case for women.
Those women who worked 55 hours or more per week had a higher risk of depression than women working a standard 35-40 hour week.
Similarly weekend working showed differences for men and women. Compared to workers who only worked on weekdays, men who worked weekends also had a greater number of depressive symptoms, but only if they had little control at work or were dissatisfied with work. Whereas for women, regardless of their control or satisfaction, working most or all weekends was linked to more depressive symptoms.
Why might women suffer more than men while working these antisocial hours?
There might be a number of reasons why women might be more affected than men:
Women who work long hours are in a minority – just four per cent of them in our sample worked 55 hours or more per week. This may place them under additional pressure.
Women working longer hours tend to be in male-dominated occupations, and this may also contribute to stress.
Women working weekends tend to be concentrated in low-paid service sector jobs, which have been linked to higher levels of depression.
Many women face the additional burden of doing a larger share of domestic labour than men, leading to extensive total work hours, added time pressures or overwhelming responsibilities.
What should be done about these risks?
Our findings should encourage employers and policy-makers to think about how to reduce the burdens and increase support for women who work long or irregular hours – without restricting their ability to work when they wish to. More sympathetic working practices could bring benefits both for workers and for employers – of both sexes.
Long work hours, weekend working and depressive symptoms in men and women: Findings from a UK population-based study by Gill Weston, Afshin Zilanawala, Elizabeth Webb, Livia Carvalho, and Anne McMunn is published in the Journal of Epidemiology and Community Health, which is published by the BMJ.
Government policy in the UK and other industrialised countries aims to increase the numbers of people staying on in work for longer – but there are significant differences between different groups. Can social and economic factors explain them? Or is there truth in the suggestion that some groups of workers are ‘resistant’ to staying in work, particularly in poorer areas? Nicola Shelton and colleagues from UCL looked at regional differencesin extending working lives and found policymakers may need to rethink their approach.
Despite the government’s stated desire for longer working lives, many workers still stop working before state pension age. The proportion of 60 year-olds in work in England and Wales is 20 per cent lower than the proportion of 50 year-olds, according to 2011 census data.
And this drop in work participation rates isn’t uniform: Existing research tells us those with lower educational qualifications – particularly women –are more likely than others to leave work early.
So, why might that be? Some official publicationshave suggested there may be resistance to continuing in work among some groups– perhaps in areas where there are fewer professional or skilled jobs, and where levels of deprivation and unemployment are high.
We wanted to find out more about this: what regional differences are there in the age at which people leave work? Are there gender differences? Are there particular factors – working conditions, household or individual factors – which can promote extended working lives? And if there are, how do they affect any regional variations?
There is some previous research on the subject.
A studyusing the ONS Longitudinal Study(ONS‐LS) and the English Longitudinal Study of Ageingfound those in lower-grade jobs, those previously unemployed, those with health problems and those with no dependent children tended to stay longer in work, along with women from Pakistani or Bangladeshi backgrounds and single women. The study included just two areas, comparing the South, East and Midlands with the North of England and Wales.
Similar evidence exists from other countries – In France, Norwayand Great Britain, links have been found between unemployment and deprivation and retirement rates.
We used census data – a one per cent sample of the total population – to look at what happened to adults who were aged between 40 and 49 in 2001. This ONS‐LS data covers more than 33,000 women and just under 32,000 men who were therefore aged 50-59 in 2011.
We found men in the North East were significantly less likely to extend their working lives than others. Those in the South West and South East were 1.6 times more likely to stay on than those in the North East, in the East of England 1.5 times, and in the East Midlands 1.4 times.
Women in all regions apart from London and Wales were significantly more likely to stay in work than those in the North East, with figures ranging from 1.15 times in the North West and West Midlands to 1.6 times in the South West.
But when we did further analysis, we found that for men at least, other social factors could explain these differences. Put bluntly, the reason men in the North East leave work earlier is because they tend to have fewer qualifications and less favourable employment status – both of which are associated with shortened working lives.
When we did the same analysis for women, we found some additional factors which affected their likelihood of staying on in work. Those in lower-skilled jobs were less likely still to be in work by 2011, along with those working for larger employers. Those who worked away from home were also more likely to have left, along with those who worked long hours.
And again, – when we considered these factors along with prior employment, health, social status and caring responsibilities, and only those in the South West were significantly more likely to stay on than those in the North East.
So, what can governments do? Given a good work environment, choosing to remain in work may have positive benefits such as maintaining good health and functioning and providing a sense of purpose- so working conditions are important.
The biggest single factor in determining whether workers stay on for longer is prior employment – and that is not likely to be changed by behavioural approaches such as the ‘nudge’ theory of behavioural economics which is popular with policy makers.
Policies that do not address issues such as low levels of education and high levels of unskilled employment can only be partially successful in enabling people to work for longer. Indeed, some groups who may have the most financial need to remain in work are most likely to leave earlier. This is particularly an issue for women.
Policies that increase skills and education in later life, rather than simply targeting those ‘receptive’ to extended working, will be more likely to make a difference.
For some people, working life comes to an end because the job is causing problems at home. Others may decide to leave – or be forced to leave – because family responsibilities are interfering with their ability to do their job. But what are the gender differences in these scenarios? Baowen Xue and colleagues from the RenEWL project at UCL found that experiencing work-family conflict influenced men and women differently.
The Government’s desire to extend our working lives is one of the most significant policy developments in recent times. Its decisions on retirement age could potentially make us healthier and wealthier, but they could also lead to greater inequality.
So, it’s important to understand the interplay, and the potential conflict, between work and home. What happens when the work-life balance just isn’t working? And who bears the brunt of that? Our new evidence suggests that where there’s a work-family conflict it’s more often women who compromise by leaving the world of work – even though their less generous pension provision might suggest they have a greater need to stay.
The population in most western societies has been ageing for the last few decades and resulting pressures on social benefits systems have increased interest in explaining when and why older people leave work. Previous studies have looked for links between leaving work and marital status, for instance, or number of dependent children. But we wanted to go further, measuring the problem over time, studying older workers in their late career stage, and looking at other factors such as health and working conditions.
These issues cut both ways, of course – for some, a heavy workload may cause problems by interfering with the time they have available for family. For others, caring for an older relative might be incompatible with work responsibilities. Either problem could have knock-on effects, such as lessening job satisfaction, forcing workers to take time off or even to quit.
There’s lots of evidence that both poor working conditions and stresses in the family are linked to early retirement, but what about these work-family conflicts? We used data from a major study of British civil servants to look at how such issues might relate to people leaving work in the later stages of their careers.
Over the last few decades, women have established themselves in the workplace, but men have been much slower to take up more domestic labour (Sullivan, 2000). Working women are often found to be primarily responsible for their families.
And men and women often have different experiences of work. When men leave their jobs, they are leaving roles that have typically dominated their whole adulthood. Women, however, are more likely to have moved in and out of the labour force and part-time jobs while managing shifting household responsibilities.
So, stopping work may have different meanings for men and women. Women, too, are less likely than men to be covered by a pension – and they may therefore be less inclined to hang on in there when family responsibilities are pressing.
We used the Whitehall II study, which followed civil servants based in London in the late 1980s and who were aged 35 to 55 when recruited to the study. We looked at data gathered from those participants during a 10-year period from the early 1990s – a sample of around 7000 people; 5000 men and 2000 women.
They were asked to say whether they felt family interfered with their work – or work with family –not at all, to some extent or a great deal, with a further category for those who didn’t have family or who felt the question was not applicable to them. They were also asked questions about whether they felt work interfered with family.
We classified those who were not working during follow-up interviews as having left due to long- sickness, retirement, unemployment or homemaking and other reasons.
We found there were significant gender differences in the decision to leave work for family reasons, whether because work was clashing with family or vice versa.
Women who experienced family interference with work were more likely to retire or leave to be a homemaker. Whereas men were more likely to stay in work if they felt family interfered with their work. Conversely, we did not find any significant link between men’s decisions to leave and a sense that work was affecting their family life. And indeed, the likelihood of retiring was lower among men who felt family was interfering with their work.
Women, though, were significantly more likely to leave work through either retirement or the homemaker route if they felt work was interfering with family – though these effects disappeared when we took other background factors such as working conditions and their sense of control within the family into account. The decisions women made were partly accounted for by factors such as caring responsibilities and sense of control in the home.
We looked at several factors that might account for relationships between work-family conflict and exit from work. Men and women with one or two dependent children, rather than none, were more likely to retire. Men who had a high degree of agency and control at work were less likely to retire, but such psychosocial working conditions were not connected with women’s retirement. Men and women with lower home control, men with three or more dependent children, and women with caring responsibilities were more likely to leave for family reasons.
We found more women had caring responsibilities than men, but more than twice as many men had dependent children in the household. Women reported higher control at home than men.
Retirement was the most frequent reason for leaving work, with just over four out of five men and just under four out of five women taking this route. More women than men left work for health or home-making reasons, and slightly more men left through unemployment. The average age at leaving was 60 years for men and 59 for women. Female homemakers were youngest when leaving work, on average 56 years.
So why the gender difference? It is possible that where there is a work family conflict for both partners, it is more likely that women will be the ones to compromise and to leave work. As women have fewer financial resources (including pension wealth) and on average contribute fewer earnings to the household than men, they may therefore have less ‘bargaining power’ on work decisions than their male partners.
But that leaves women in a double-bind: they are the ones to leave early, but that diminishes their chances of increasing an already smaller pension pot. So, what can policy-makers do?
Adjustments in the workplace, such as flexible working hours and higher social support, could reduce work-family conflict and help these women to remain in work.
We have known for some time that work-family conflict could be an important issue for younger people with children, but our study underscores the importance of this issue for older people’s labour market participation too. As women tend to retire at a younger age than men, and as pressures on social benefits systems are increasing due to an ageing population, it is important for policy-makers to think hard about finding ways to reduce work-family conflict for women across working life.
Across Europe, there’s good news for older people – life expectancy is on the rise and levels of disability among older people are falling. But there are concerns that a longer life may not be a better life for all. So who benefits from increased life expectancy? Jenny Head and colleagues from the IDEAR network find those with a higher occupational status can expect the greatest number of years of healthy, disease-free life.
We know from lots of studies that there are big differences in life expectancy between different social groups. And we know that those in higher social positions tend to benefit more from that rise in healthy life expectancy.
But, given that many governments expect people to extend their working lives, we specifically need to know about the different expectations of people in different occupational positions – which is slightly different.
Together with colleagues in the IDEAR networK, we looked at what those from different occupational backgrounds might expect in later life – to be precise, how many years with good health can they expect to enjoy between the ages of 50 and 75?
The data came from four cohort studies in England, Finland, France and Sweden.
We were able to look at data from 9,213 people in the English Longitudinal Study of Ageing from 2002 onwards. We also had information on 42,978 people who took part in the Finnish Public Sector study between 1997 and 2013. In France, we used the GAZEL Cohort Study, which gathered information from 18,263 people working for the national utility company from 1989 onwards. And in Sweden, we looked at a sample of 8,186 people who responded to the Swedish Longitudinal Occupational Survey of Health between 2003 and 2014.
We used two health measures: whether participants rated their own health as good or poor, and whether they had ever been diagnosed with heart disease, stroke, chronic lung disease, cancer or diabetes.
In all the cohorts, people in lower occupational positions could expect fewer years of life than those in higher occupational positions – and they could expect to spend fewer of those remaining years in good health.
So in England, both men and women in high-grade occupations could expect more than four years’ extra healthy life when compared with men and women in lower-grade occupations. In Finland that gap was wider, with those in high-grade jobs expecting at least six and a half years more good health. In France the difference was around two and a half years, while Sweden had the smallest gap of a little more than two years.
This pattern was consistent across the four countries and for both men and women. There were also socioeconomic inequalities in chronic disease-free life expectancy, although these differences were less marked than for self-rated health.
Why does this matter? A better understanding of the future health of older people is crucial to policy-makers because it affects public expenditure on income, health and long-term care. It also matters because governments want to extend working lives and increase State Pension ages, and in order to do that they need older workers to stay healthy.
Our results indicate that those in lower socioeconomic positions may be doubly disadvantaged because they have worse health but may also need to work longer for financial reasons. To achieve extended working lives for all, policy-makers will need to find ways of reducing those social class differences in health expectancies.
Socioeconomic differences in healthy and disease-free life expectancy between ages 50 and 75: a multi-cohort study, by Jenny Head, Holendro Singh Chungkham , Martin Hyde, Paola Zaninotto, Kristina Alexanderson, Sari Stenholm, Paula Salo, Mika Kivimäki, Marcel Goldberg, Marie Zins, Jussi Vahtera and Hugo Westerlund, is published in the European Journal of Public Health.
The post-war ‘baby boom’ generation in developed countries is reaching retirement age – and this is placing strain on welfare systems. Sol Richardson and colleagues from the ESRC International Centre for Lifecourse Studies at UCL find the type of welfare system under which we live can affect our prospects of having a happy and fulfilled retirement.
We know stopping work can lead to changes in our sense of personal wellbeing – both positive and negative. And we know this can be influenced by a range of factors, such as whether an individual has left work at the usual age or has stopped early.
There are other factors which can make a difference to how we fare after retirement, too: If we were dismissed, retired through illness or through unemployment, for instance, the change is more likely to hit us hard.
But how much difference do the different types of welfare system which exist in different countries make to those who leave work early? Until now we haven’t had much clear evidence on this point.
We looked at a sample of people from 16 countries, using data from the Study of Health, Ageing and Retirement in Europe (SHARE) between 2004 and 2013, and from the English Longitudinal Study of Ageing (ELSA) between 2002 and 2013 – these are studies which revisit their participants over time.
Our subjects were aged 50 years and over and had been visited before and after they left work.
We looked at a total sample of 8037 respondents who had left work between 2002 and 2013 and for whom we had information not only on work history but also on personal wellbeing.
We categorised how people left work according to the type of benefit they received afterwards: Were they receiving disability benefit, unemployment benefit, sickness benefit, social assistance, early retirement pension, old age pension or none of those?
Retirement age is different in different countries – it can depend on gender or on the number of years worked, and it’s been rising in many countries. So we defined retirement as the earliest age at which an individual can draw a full pension if he or she has been working since the age of 20.
And we looked at the wellbeing of our subjects, using a validated scale called CASP-12 (control, autonomy, self-realization and pleasure.)
And then we compared these findings according to the type of welfare regime the participants had in their home countries – again using an internationally-recognised scheme that relates to how social benefits are granted and organized.
We found that those who left the labour market because of unemployment or disability and who left outside of the typical time-frame tended to experience negative effects on their personal wellbeing.
How much difference did country of residence make? We found this was significant, but that only a small proportion of the difference was down to the country itself. Almost two thirds of the wellbeing gaps we found between individuals in different countries could be accounted for, we found, by the type of welfare system they had.
Those living in Scandinavian social democratic welfare systems experienced the most positive transitions – but this effect is unlikely to be down to expenditure alone. Other factors could be important – for instance, employment rules guiding the ways people left work. Different finance mechanisms, the extent of benefit coverage and the eligibility regime for those benefits could also have an effect.
When we looked at the different types of welfare system we found people in systems which could be described as ‘Bismarckian,’ such as France or Germany, or ‘Scandinavian,’ such as Sweden or Denmark, did better than those in systems which could be categorised as ‘Mediterranean,’ such as Italy or Greece.
As a generalisation, Scandinavian systems can be described as Social Democratic. They spend the most, they have high levels of cash benefits and a strong emphasis on services.
Bismarckian countries emphasise earnings-related cash benefits like pensions and they provide reasonable services, but not at the level of Social Democratic countries.
In Mediterranean countries, the pensions system is fragmented and services are rudimentary. People living in Mediterranean systems are more likely to rely on family and the voluntary sector for support.
What lessons should policy-makers draw from our study? We found that higher expenditure per head, particularly expenditure on non-healthcare services such as home help, did help our participants to feel better after they left paid work.
And our results have important implications for welfare policy: They underscore the importance of welfare services as greater numbers of workers approach retirement age and leave the labour market.
Country-level welfare-state measures and change in wellbeing following work exit in early old age: evidence from 16 European countries, by Sol Richardson, Ewan Carr, Gopalakrishnan Netuveli and Amanda Sacker, is published in the International Journal of Epidemiology, 2018, 1–13.