Educational differences in the influence of health on early work exit among older workers

Abstract

ObjectivesPrevious research has shown that poor physical and mental health are important risk factors for early work exit. We examined potential differences in this association in older workers (50+) across educational levels.MethodsCoordinated analyses were carried out in longitudinal data sets from four European countries: the Netherlands (Longitudinal Aging Study Amsterdam), Denmark (Danish Longitudinal Study of Ageing), England (English Longitudinal Study of Ageing) and Germany (German Ageing Survey). The effect of poor self-rated health (SRH), functional limitations and depression on different types of early work exit (early retirement, economic inactivity, disability and unemployment) was examined using Cox regression analysis. We examined educational differences in these effects by testing interaction terms.ResultsPoor physical and mental health were more common among the lower educated. Poor SRH, functional limitations, and depression were all associated with a higher risk of early work exit. These health effects were strongest for the disability exit routes (poor SRH: HRs 5.77 to 8.14; functional limitations: HRs 6.65 to 10.42; depression: HRs 3.30 to 5.56). In the Netherlands (functional limitations) and England (functional limitations and SRH), effects were stronger in the lower educated.ConclusionsThe prevalence of health problems, that is, poor SRH, functional limitations and depression, was higher in the lower educated workers. All three health indicators increase the risk of early work exit. In some countries, health effects on early exit were stronger in the lower educated. Thus, lower educated older workers are an important target group for health policy and intervention.

Inability to Work Fulltime, Prevalence and Associated Factors Among Applicants for Work Disability Benefit

“…In our study, higher education has a strong positive association with inability to work fulltime compared to lower and middle educational level. This seems to be in contrast with findings from other studies describing that higher educated workers are better able to adjust their work and are less work disabled than lower educated workers who are considered to be more vulnerable, have more health problems and worse working conditions [ 43 – 45 ]. In search for explanations for this difference, we explored if the higher educated workers in our study sample had more often diseases related with higher odds for inability to work fulltime, however this was not the case (data not shown).…”

Working Conditions and Health Among Italian Ageing Workers

“…Another study combining data from SHARE and ELSA estimated an overall prevalence of depressive symptoms of 14% among workers 50-64 years (Siegrist et al, 2012), similar to that observed in a Swedish study (Nyberg et al, 2019). However, lower prevalences of depression, more similar to what we found, have been observed in other studies among ageing workers (De Breij et al, 2020;Leijten et al, 2015;Mezuk et al, 2011). Anyway the variability in mental disorders prevalences in different countries was expected, as diagnosis and treatment of common mental disorders (i.e.…”

The differentiated roles of health in the transition from work to retirement – conceptual and methodological challenges and avenues for future research

“…This is in line with findings from a Dutch study conducted by van den Berg et al (47). Recent findings by de Breij et al (18) confirm this for Denmark when analyzing prospective data but not for The Netherlands and England, where the effects of functional limitations on disability pension were strongest. With respect to early retirement, only self-perceived health was a significant predictor in the meta-analysis (7).…”

“…De Wind et al (17) found support for the hypothesis that ability and opportunity to work mediate the relation between health and early retirement. De Breij et al (18) showed that in some countries health effects on early work exit were stronger in the lower educated. This is in line with…”

“…Wikman et al (46) criticize that in public health research, "concepts of ill health are often seen as interchangeable alternatives". Indeed, there are indications that the researchers' choice of health indicator matters when investigating the health-retirement association (18). This becomes obvious when taking, for example, the health concept trilogy of "illness", "disease", and "sickness"; "illness" refers to the general ill health a person may perceive, "disease" indicates specific diagnosed health conditions and "sickness" relates to social consequences of poor health such as sickness absence.…”