Your retirement and my health behavior: Evidence on retirement externalities from a fuzzy regression discontinuity design

Retirement and health plan choice

Many consumers exhibit choice persistence, often sticking with suboptimal or dominated health plans. We analyze the effect of retirement on health plan choice using a fuzzy regression discontinuity design that exploits Switzerland's old-age pension legislation. Drawing on insurance claims data from 84,731 individuals aged 61 to 68 over the years 2006-2014, we find that retirement significantly increases switching from the standard model to managed care plans, which offer lower premiums but restrict access to specialist care. However, deductible choices remain largely unaffected, as retirees are no more likely to select the cost-minimizing deductible than their non-retired counterparts. We conclude that while retirement may encourage plan switching, many consumers still choose dominated options, underscoring the need for a richer policy framework that provides consumer guidance incorporating measures such as personalized information interventions and simplified choice architectures to promote better health plan choices.

Effect of retirement on the body mass index in China: a nationwide study based on the regression discontinuity design

INTRODUCTION

Retirement represents a significant life transition and is associated with individual health outcomes. Previous studies on the health effects of retirement have yielded inconsistent conclusions. This study aimed to estimate the impact of retirement on the body mass index (BMI) and BMI-defined overweight and obesity.

METHODS

Between 2012 and 2015, this study included 88,471 public sector participants from the Chinese Hypertension Survey (CHS) while excluding those working in the private sector. By utilizing the fuzzy regression discontinuity design (FRDD), this research evaluated the direct impact of retirement on the BMI, as well as on the overweight and obesity rates. Additionally, the study examined variations in the effects of retirement among groups stratified by sex and educational attainment.

RESULTS

The fully adjusted model suggested that retirement did not have a significant impact on the BMI or overweight and obesity rates of the overall population. Notably, retirement significantly impacted the male participants, resulting in an increase in their BMI of 2.18 (95% CI 0.23-4.13), but did not affect the BMI of the female participants. Furthermore, individuals with lower educational backgrounds experienced more pronounced BMI changes upon retirement.

CONCLUSIONS

On average, retirement has no significant impact on the BMI and overweight and obesity rates. Retirement leads to an increase in the BMI among men but does not affect that in women. When considering adjustments to existing retirement policies, the differential health effects of retirement across various populations should be taken into account.

The impact of spousal retirement on health-an empirical analysis based on CFPS

Introduction

Health impacts associated with spousal retirement vary significantly across countries and datasets, underscoring the need to examine this relationship within the Chinese context. This study aims to explore how spousal retirement affects individual health in China.

Methods

Utilizing data from the China Family Panel Studies (CFPS) for the years 2014, 2016, 2018, and 2020, this research applies a fuzzy regression discontinuity approach to assess the effects of spousal retirement on health outcomes.

Results

Findings indicate that a wife's retirement positively impacts her husband's mental health but negatively affects his physical health. Conversely, a husband's retirement improves his wife's self-rated health. Further analysis reveals that a husband's retirement significantly enhances his wife's marital satisfaction, contributing to longer sleep durations and, subsequently, better self-rated health.

Discussion

This study highlights the nuanced effects of spousal retirement on individual health, with implications for understanding the marital and health dynamics within aging populations in China.

Marital rights: Lived experiences of Iranian women with retired spouses in a qualitative study

BACKGROUND

The aim of the present study was to analyze the lived experiences of Iranian women living with their retired spouses in relation to their marital rights.

METHODS

The research method was qualitative and descriptive phenomenology. The statistical population included women living with their retired spouses in the city of Isfahan, and the sample consisted of 15 women. Data were collected through semistructured interviews, with three general questions on emotional rights, economic rights, and sexual rights, and were approved by five experts. Data were analyzed using the seven-step Colaizzi method.

RESULTS

After transcribing the interviews and coding the data, the following axial codes were identified. Emotional rights included the two categories of camaraderie and dissatisfaction. Economic rights included the four categories of economic management, economic well-being, respect for women's economic property, and economic problems. Finally, sexual rights consisted of the two categories of satisfaction and dissatisfaction with sexual relationships. The results showed that some participants were satisfied with the implementation of their rights during their spouse's retirement, while others were dissatisfied. Most current marital problems related to emotional, economic, and sexual rights result from past and unresolved marital life conflicts that lead to the escalation of family tensions.

CONCLUSIONS

According to the dissatisfied participants, the best strategy for resolving these problems was to "sweep them under the rug,", i.e., to rehire the men and protest the lack of support for the retirees by the state organization. In contrast, satisfied participants played an important role in solving the problems and actively dealt with their spouse's retirement rather than taking a passive and protesting role to realize their marital rights.

The Asymmetric Spillover Effects of Retirement on Disability: Evidence From China

Background and Objectives

Recent research has explored the spillover effects of retirement on spousal well-being, yet limited attention has been given to the short-term impact on spousal disability. This study explored the asymmetric spillover impact of retirement on spouses' disability severity among a national cohort of urban residents in China.

Research Design and Methods

Utilizing 4 waves of data (2011-2018) from the China Health and Retirement Longitudinal Survey, we employ a nonparametric regression discontinuity design to estimate the short-term effect of retirement on spousal disability severity. Disability is assessed based on their ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Furthermore, we conduct heterogeneity analysis stratified by factors such as the husband's retirement status, health conditions, lifestyle behaviors, and the wife's educational level. Additionally, we explore potential mechanisms including changes in health behaviors, emotions, and disease diagnoses.

Results

Our findings indicate that wives' retirement has a significant favorable short-term effect on husbands' ADL scores, with a magnitude of -0.644 points (-9.78% relative to baseline). A significant beneficial effect of wives' retirement on the prevalence of husbands' difficulty in dressing, bathing, and eating was observed with substantial magnitudes of 0.075, 0.201, and 0.051 points, respectively. Various heterogeneity analyses and sensitivity tests confirmed the robustness of our results. The positive spillover effect of wives' retirement likely results from reduced negative emotions in husbands. In contrast, husbands' retirement does not affect the prevalence of ADL/IADL disability in their wives.

Discussion and Implications

Underscoring the gender asymmetry in the effects of spousal retirement on disability, this study emphasizes the need for tailored policies considering men's and women's distinct disability experiences.

The effect of retirement eligibility on mental health in the United Kingdom: Heterogeneous effects by occupation

I investigate heterogeneity across occupational characteristics in the effect of retirement eligibility on mental health in the United Kingdom. I use K-means clustering to define three occupational clusters, differing across multiple dimensions. I estimate the effect of retirement eligibility using a Regression Discontinuity Design, allowing the effect to differ by cluster. The effects of retirement eligibility are beneficial, and greater in two clusters: one comprised of white-collar jobs in an office setting and another of blue-collar jobs with high physical demands and hazards. The cluster with smaller benefits mixes blue- and white-collar uncompetitive jobs with high levels of customer interaction. The results have implications for the distributional effect of raising the retirement age.

The impact of retirement on blood pressure: evidence from a nationwide survey in China

INTRODUCTION

The health impact of retirement is controversial. Most previous studies have been based on self-reported health indicators or the endpoints of some chronic diseases (e.g., morbidity or mortality), but objective physiological indicators (e.g., blood pressure) have rarely been used. The objective of this study is to elucidate the health effects of retirement on blood pressure, thereby offering empirical evidence to facilitate the health of retirees and to optimize retirement policies.

METHODS

From 2012 to 2015, 84,696 participants of the Chinese Hypertension Survey (CHS) were included in this study. We applied the fuzzy regression discontinuity design (FRDD) to identify retirement's causal effect on systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure. We also explored the heterogeneity in the effects of retirement across different sex and education level groups.

RESULTS

Based on the fully adjusted model, we estimated that retirement increased SBP by 5.047 mm Hg (95% CI: -2.628-12.723, P value: 0.197), DBP by 0.614 mm Hg (95% CI: -3.879-5.108, P value: 0.789) and pulse pressure by 4.433 mm Hg (95% CI: -0.985-9.851, P value: 0.109). We found that retirement led to a significant increase in male participants' SBP and pulse pressure as well as a possible decrease in female participants' blood pressure. Additionally, the blood pressure levels of low-educated participants were more vulnerable to the shock of retirement.

CONCLUSION

Retirement is associated with an increase in blood pressure level. There is a causal relationship between the increase in blood pressure levels of men and retirement. Policy-makers should pay extra attention to the health status of men and less educated people when adjusting retirement policies in the future.

Reducing carbon emissions at the expense of firm physical capital investments and growing financialization? Impacts of carbon trading policy from a regression discontinuity design

This study examines the effects of China's carbon trading policy on firm emissions and explores its impact mechanisms through financial and physical asset investments. The empirical analysis utilizes a fuzzy regression discontinuity design based on a sample of 427 industrial firms in China between 2014 and 2019. The results indicate that China's carbon trading policy incentivized firms to increase their financial investments while simultaneously discouraging physical capital investments. These shifts in investment patterns helped firms achieve their emission reduction targets. The study reveals that carbon trading policy in China has contributed to the financialization of firms, resulting in the erosion of firm assets and a decline in their overall competitiveness. Based on these findings, some policy recommendations are put forward.

The effects of parental retirement on adult children's health: Evidence from China

Using representative data from China, we examine the causal effects of parental retirement on the health of adult children. To do so, we adopt a fuzzy regression discontinuity design and exploit the mandatory retirement ages in China as cut-off points. We find no evidence that parental retirement has significant effects on the mental health, healthcare utilization, or risky health behaviors of adult children. However, paternal retirement and maternal retirement have different effects on adult children's Self-reported health (SRH). Paternal retirement has a significantly negative effect only on the SRH of sons, while maternal retirement does not induce such effects. Potential mechanisms of intergenerational transfer through which parental retirement might affect adult children's health are also explored.

Unplanned Costs and Benefits: Gender and Spousal Spillover Effects of Retirement on Health

Objective

Our study assesses how women and men's health indicators are shaped by their spouse's retirement.

Background

The retirement process can reshape the health of a retiree, but these effects can also extend onto the health of spouses. Although past research has largely focused on how men's retirement might negatively shape their wife's health outcomes, it is possible that wives' retirement has detrimental effects on their husband's health as well.

Method

Using data from the Health and Retirement Study (HRS), we employ a fuzzy regression discontinuity design to identify the causal effects of spousal retirement on indicators of physical and mental health in married older adults.

Results

Our results suggested that men, not women, experience the most negative spousal spillover effects of retirement on their health outcomes. We found the most support for spillover effects on spouses' physical health outcomes. Additionally, men who are not working when their spouse retires experienced the most negative health effects.

Conclusion

Women and men's health is differentially affected by spousal retirement, where men might be the most negatively affected by their spouses' transition in the U.S. context. These results contradict conventional wisdom that undergirds numerous untested assumptions underlying prior research on this significant life transition.

Retirement and cardiovascular disease: a longitudinal study in 35 countries

BACKGROUND

Many countries have been increasing their state pension age (SPA); nonetheless, there is little consensus on whether retirement affects the risk of cardiovascular disease (CVD). This study examined the associations of retirement with CVD and risk factors.

METHODS

We used harmonized longitudinal datasets from the Health and Retirement Study and its sister surveys in 35 countries. Data comprised 396 904 observations from 106 927 unique individuals aged 50-70 years, with a mean follow-up period of 6.7 years. Fixed-effects instrumental variable regressions were performed using the SPA as an instrument.

RESULTS

We found a 2.2%-point decrease in the risk of heart disease [coefficient = -0.022 (95% confidence interval: -0.031 to -0.012)] and a 3.0%-point decrease in physical inactivity [-0.030 (-0.049 to -0.010)] among retirees, compared with workers. In both sexes, retirement was associated with a decreased heart disease risk, whereas decreased smoking was observed only among women. People with high educational levels showed associations between retirement and decreased risks of stroke, obesity and physical inactivity. People who retired from non-physical labour exhibited reduced risks of heart disease, obesity and physical inactivity, whereas those who retired from physical labour indicated an increased risk of obesity.

CONCLUSIONS

Retirement was associated with a reduced risk of heart disease on average. Some associations of retirement with CVD and risk factors appeared heterogeneous by individual characteristics.

Transition to retirement impact on smoking habit: results from a longitudinal analysis within the Survey of Health, Ageing and Retirement in Europe (SHARE) project

BACKGROUND

In an ageing society, retirement impacts on behavioural risk factors and health outcomes should be carefully assessed. Scant evidence exists from longitudinal studies on the short- and long-term consequences of the transition to retirement on smoking habit.

METHODS

We conducted a longitudinal study based on the Survey of Health, Ageing and Retirement in Europe (SHARE) data from 27 European countries plus Israel collected in 2004-2020. To estimate relative risks (RR) and corresponding 95% confidence intervals (CI) for smoking status and intensity at seven time periods before and after retirement, we fitted adjusted generalised estimating equation (GEE) models for repeated measures.

RESULTS

We selected a cohort of 8998 individuals employed at baseline and retired at follow-up (median follow-up time: 9 years; maximum: 16 years). As compared to the year of retirement, the RR of smoking was 1.59 (95% CI 1.44-1.76) at 10 years or more before retirement, 1.35 (95% CI 1.25-1.46) from 5 to 9 years before retirement, and 1.18 (95% CI 1.10-1.27) from 1 to 4 years before retirement. Smoking steadily decreased after retirement, being 0.94 (95% CI 0.87-1.01) from 1 to 4 years after retirement, 0.76 (95% CI 0.69-0.84) from 5 to 9 years, and 0.58 (95% CI 0.46-0.74) 10 years or more after retirement. In smokers, the estimated number of cigarettes smoked/day decreased from about 27 cigarettes/day at 10 years or more before retirement to 9 cigarettes/day at 10 years or more after retirement (p trend < 0.001).

CONCLUSION

Longitudinal data suggest that lifestyles might favourably change with retirement. Further studies are needed to direct healthy ageing promotion policies better.

Spillover effects of retirement: Does health vulnerability matter?

The current literature investigating the impact of retirement and the associated spousal spillover effects overlooks the unintended effects of retirement on spouses in vulnerable health, namely spouses with long-term health conditions (LTHCs). In this paper, we fill this gap in the literature and investigate the impact of an individual's retirement on their partner's health outcomes when their partner has LTHCs. Given the inherent identification challenges associated with entry into retirement, we use the pension-qualifying age in Australia as an instrument. Based on data from the Household Income and Labour Dynamics in Australia survey, we find that the husband's retirement has a positive impact on the wife's quality-adjusted life years (QALY) and other physical and mental health outcomes. We also identify redistribution of domestic workload as a key transmission mechanism of the spousal spillover effects. Women with LTHCs will see their QALY and health improve only if their husband devotes more time to domestic tasks after retirement.

Does raising retirement age lead to a healthier transition to retirement? Evidence from the U.S. Social Security Amendments of 1983

Governments are under pressure to raise the retirement age in response to an aging population and low fertility rates. However, the literature has not reached a consistent conclusion on the health effects of extending working lives. Furthermore, while most studies have concentrated on post-retirement health consequences, the health outcomes during the transition from work to retirement have been overlooked. Therefore, this article focuses on the transition period - the time between the early benefit age and full retirement age. Exploiting the increase in retirement age introduced by the U.S. Social Security Amendments of 1983, the difference-in-difference estimation finds that the reform successfully encouraged more people to work longer and claim benefits later, whilst having no adverse influence on health during the transition period. This paper infers that the desirable impacts of the 1983 amendments could be partly attributed to the adequate preparation time the reform left to the public.

How the Spouse's Retirement Affects the Cognitive Health of Individuals in China: A Fresh Evidence From the Perspective of Social Interaction

Background: With the rapid aging of global population, the health consequences of retirement reform are debated greatly. However, most previous studies are limited to the effects on individual themselves, and pay scant attention to the social interaction between individuals and their spouse which may induce the social multiplier effect of retirement. Driven by the practical and academic motives, this study investigates the impacts of the spouse's retirement on the individual's cognitive health among Chinese dual-earner couples.

Methods: We first build a simultaneous-equations model. Then, using the data from the 2010 to 2018 China Family Panel Studies (CFPS), we choose the fixed-effects model and adopt the fuzzy regression discontinuity design method to analyze. Besides, we check the validity and robustness of the results. Finally, we employ the mediating effect model to explore the mechanisms.

Results and Conclusions: The spouse's retirement has significantly negative direct and indirect effect on individual cognitive health. Husbands' retirement has a stronger adverse spillover effect than wives' retirement, and wives' cognitive health is more vulnerable to the social interaction effect. The direct spillover effect of husbands' retirement is −0.503 and that of wives' retirement is −0.312, the indirect spillover effect of husbands' retirement is −0.36 and that of wives' retirement is −0.279. In addition to the social interaction effect of cognition between the couples, we also find that the decrease in household income is an important mechanism, and that the increased exercise frequency can somewhat mitigate the adverse spillover effect.

Self-Perception or Objective State: A Further Study of the Effects of Retirement on Health

Against the backdrop of an aging global population and the increasing pressure of medical care expenditures for seniors, this paper used a fuzzy regression discontinuity (FRD) model to explore the effects of retirement on the self-assessed health and objective physical and mental health of older people. Using survey data from the China Health and Retirement Longitudinal Study (CHARLS), our model addresses some relevant academic controversies. Our sample was comprised of male respondents from government agencies, enterprises, and public institutions. The research explored the impact of retirement on lifestyle habits and included an in-depth analysis of the mechanism through which retirement influences different aspects of health. The results show that: (1) Retirement does not have any significant impact on objective health, including depression and self-care ability, but it does cause a notable decline in subjective health assessment. (2) Retirement shortened the sleep time of respondents, which may account for lower scores on subjective health self-evaluations, but it did not lead to any noticeable improvement in habits which are harmful to health, such as smoking and drinking. (3) Marriage can help alleviate the problems of depression and smoking among older people, and education has a somewhat broader positive effect on their health and lifestyles; however, neither factor helps to improve the sleep problems of older people. Therefore, this paper recommends that efforts should be made to both optimize retirement policies and seek further ways to improve the health of the retired population.

Healthcare utilization at retirement in China

Previous studies, mostly analyzing data from high-income economies, present mixed evidence on the relationship between retirement and healthcare utilization. This study leverages administrative data for over 80,000 urban Chinese workers to explore the effect of retirement on outpatient and inpatient care utilization using a fuzzy regression discontinuity design. The analyses of medical claims from a large city in China complement and extend the current literature by providing evidence of potential mechanisms underlying increased short-run utilization. In this relatively well-insured population, annual total healthcare expenditures significantly increase primarily because of more intensive use of outpatient care at retirement, especially at the right tail of the distribution of outpatient visits. This increase in outpatient care appears to stem from a decline in the patient cost-sharing rate and the reduced opportunity cost of time upon retirement, interacting with supplier-induced demand, not from any sudden impact on health. We do not find evidence of change in inpatient care at retirement. The results hold for both females and males, and are robust to a number of sensitivity analyses.

Family health spillovers: evidence from the RAND health insurance experiment

I study how family spillovers shape healthcare consumption through two main sources: a learning channel whereby family members share information about their health insurance and the effectiveness of healthcare, and a behavioral channel whereby risk perception and habits are shared and transmitted. I exploit two types of sudden health shocks to identify a causal effect operating through each channel: a spouse's non-fatal heart attack or stroke and a severe injury to a child. I incorporate these shocks into an event-study framework to quantify the effect of spillovers on healthcare consumption of a non-injured adult family member. I find a significant behavioral spillover effect of an increase of more than 200% in medical expenditure of preventive care over a four-year horizon. Moreover, I find a strong and persistent learning spillover that amounts to an average increase of more than 150% in medical expenditure relative to prior to the health shock, and I demonstrate that this effect promotes health investment. While the first result is in line with previous findings in the literature, the second is novel.

Respite, renewal, retirement and tensions: Australian Men's Sheds and the impact on significant others

The health and wellbeing benefits of Men's Sheds to the men who participate have had significant research attention for over a decade. However, there has been little research into the broader impacts of Men's Sheds, particularly in relation to the impacts on significant others in the lives of the men who participate. Our paper aims to redress this lack of research by focusing on the interrelated perceptions and experiences of men and those closest to them in four Men's Sheds in regional Victoria, Australia. The research shows that the partners and carers of ‘shedders’ reported that the men's participation not only benefited the men but also had benefits for their significant others. The study also showed that the partners of shedders in the study found that their individual and joint adjustment to retirement was in some cases assisted by the men enjoying the social and structured environment of the Men's Shed, while in other cases it was seen by partners as an over-commitment and impacting negatively on the marriage. The findings also shed some important light on some tensions experienced by the partners associated with carer burden and adjustments to retirement.

The Impact of Retirement on Cardiovascular Disease and Its Risk Factors: A Systematic Review of Longitudinal Studies

Background and Objectives

People are now spending longer in retirement than ever before and retirement has been found to influence health. This study systematically reviewed the impact of retirement on cardiovascular disease (CVD) and its risk factors (metabolic risk factors, blood biomarkers, physical activity, smoking, drinking, and diet).

Research Design and Methods

Longitudinal studies published in Medline, Embase, Social Science Citation Index, PsycINFO, and Social Policy and Practice were searched. No language restrictions were applied if there was an English abstract. Eighty-two longitudinal studies were included after critical appraisals.

Results

Studies in the United States often found no significant effect of retirement on CVD, while studies in European countries, except France, showed a detrimental effect of retirement on CVD. Results from the United States and several European countries consistently show that retirement increase adiposity measures among those retired from physically demanding jobs. For diabetes and hypertension, five out of nine studies suggest no effect of retirement. Retirement has been repeatedly linked to increasing leisure-time physical activity but may reduce work- and transport-related physical activity in turn. Most studies showed that retirement either decreased smoking or had no effect on smoking. The evidence did not show a clear conclusion on drinking. Only a few studies have assessed the impact on diet and blood biomarkers.

Discussion and Implications

Effect of retirement varies according to the health outcomes studied and country of the study population. Policy concerning extending the retirement age needs to focus on ensuring they are suited to the individual.

Probing the Effective Treatment Thresholds for Alteplase in Acute Ischemic Stroke With Regression Discontinuity Designs

Randomized Controlled Trials (RCTs) are considered the gold standard for measuring the efficacy of medical interventions. However, RCTs are expensive, and use a limited population. Techniques to estimate the effects of stroke interventions from observational data that minimize confounding would be useful. We used regression discontinuity design (RDD), a technique well-established in economics, on the Get With The Guidelines-Stroke (GWTG-Stroke) data set. RDD, based on regression, measures the occurrence of a discontinuity in an outcome (e.g., odds of home discharge) as a function of an intervention (e.g., alteplase) that becomes significantly more likely when crossing the threshold of a continuous variable that determines that intervention (e.g., time from symptom onset, since alteplase is only given if symptom onset is less than e.g., 3 h). The technique assumes that patients near either side of a threshold (e.g., 2.99 and 3.01 h from symptom onset) are indistinguishable other than the use of the treatment. We compared outcomes of patients whose estimated onset to treatment time fell on either side of the treatment threshold for three cohorts of patients in the GWTG-Stroke data set. This data set spanned three different treatment thresholds for alteplase (3 h, 2003-2007, N = 1,869; 3 h, 2009-2016, N = 13,086, and 4.5 h, 2009-2016, N = 6,550). Patient demographic characteristics were overall similar across the treatment thresholds. We did not find evidence of a discontinuity in clinical outcome at any treatment threshold attributable to alteplase. Potential reasons for failing to find an effect include violation of some RDD assumptions in clinical care, large sample sizes required, or already-well-chosen treatment threshold.

Time to care? The effects of retirement on informal care provision

This paper analyzes the impact of women's retirement on their informal care provision. Using SOEP data, we address fundamental endogeneity problems by exploiting variation in the German pension system in two complementary ways. We find a significant effect of retirement on informal care provision, when using early retirement age thresholds as instruments. Heterogeneity analyses confirm the underlying behavioral mechanism, a time conflict between labor supply and informal care. We further exploit a sizable increase in the early retirement age for German women and find that affected women provide less non-intensive care. High intensity care is not impacted, which leads to a double burden and potentially negative health effects for caregivers. Exploiting the policy reform, we find evidence supporting the notion that formal care is no substitute for informal care. This implies that less overall care is received, which can be damaging to the health of the recipients of care.

The effect of retirement on biomedical and behavioral risk factors for cardiovascular and metabolic disease

Retirement is a major life event potentially associated with changes in relevant risk factors for cardiovascular and metabolic conditions. This study analyzes the effect of retirement on behavioral and biomedical risk factors for chronic disease, together with subjective health parameters using Southern German epidemiological data. We used panel data from the KORA cohort study, consisting of 11,168 observations for individuals 45-80 years old. Outcomes included health behavior (alcohol, smoking, physical activity), biomedical risk factors (body-mass-index (BMI), waist-to-hip ratio (WHR), glycosylated hemoglobin (HbA1c), total cholesterol/HDL quotient, systolic/diastolic blood pressure), and subjective health (SF12 mental and physical scales, self-rated health). We applied a parametric regression discontinuity design based on age thresholds for pension eligibility. Robust results after p-value corrections for multiple testing showed an increase in BMI in early retirees (at the age of 60) [β = 1.11, corrected p-val. < 0.05] and an increase in CHO/HDL in regular retirees (age 65) [β = 0.47, corrected p-val. < 0.05]. Stratified analyses indicate that the increase in BMI might be driven by women and low educated individuals retiring early, despite increasing physical activity. The increase in CHO/HDL might be driven by men retiring regularly, alongside an increase in subjective physical health. Blood pressure also increased, but the effect differs by retirement timing and sex and is not always robust to sensitivity analysis checks. Our study indicates that retirement has an impact on different risk factors for chronic disease, depending on timing, sex and education. Regular male, early female, and low educated retirees should be further investigated as potential high-risk groups for worsening risk factors after retirement. Future research should investigate if and how these results are linked: in fact, especially in the last two groups, the increase in leisure time physical activity might not be enough to compensate for the loss of work-related physical activity, leading thus to an increase in BMI.

The impact of life events and transitions on physical activity: A scoping review

BACKGROUND

Physical activity (PA) is a fluctuating behavior and prone to change across the life course. Changes in PA may be particularly due to the experience of life events and transitions. For well-timed and successful PA interventions, it is important to understand when and why individuals take up or terminate PA.

OBJECTIVES

This scoping review aims to examine the extent, range, and nature of research on the impact of life events and transitions on PA and to summarize key findings.

METHODS

A systematic literature search was conducted in PubMed, PsycINFO, PsycARTICLES, SPORTDiscus, and Web of Science. Articles were included if they had been published in peer-reviewed journals between 1998 and 2020 and assessed the impact of at least one life event or transition on PA.

RESULTS

107 studies that assessed 72 distinct life events and transitions were included and summarized in ten categories. Events and transitions that are primarily associated with decreases in PA were starting cohabitation, getting married, pregnancy, evolving parenthood, and the transitions from kindergarten to primary school, from primary to secondary school, and from high school to college or into the labor market. Retirement was associated with increases in PA; yet, long-term trajectories across retirement indicated a subsequent drop in activity levels. Divorce was associated with no changes in PA. No trends could be identified for changing work conditions, quitting or losing a job, starting a new relationship, widowhood, moving, and diagnosis of illness.

CONCLUSION

Life events and transitions can be conceptualized as natural interventions that occur across the life course and that are oftentimes associated with changes in PA behavior. Our study indicates that, despite some emerging trends, similar events do not necessarily have similar impacts on PA across individuals. It also shows that the research landscape is characterized by a lack of conceptual clarity and by disparate methodologies, making it difficult to synthesize results across studies.

What Factors Affect the Evolution of the Wife's Mental Health After the Husband's Retirement? Evidence From a Population-Based Nationwide Survey in Japan

BACKGROUND

The "retired husband syndrome" refers to the negative impact of the husband's retirement on the wife's health. This study provided new insights by examining whether and to what extent the wife's social participation, interactions with her husband, and job status prior to her husband's retirement affected the evolution of her mental health after her husband's retirement.

METHODS

We collected data from a 12-wave nationwide panel survey conducted from 2005 to 2016, starting with individuals aged 50-59 years. Focusing on 3,794 female respondents whose husbands retired during the survey period, we applied random-effects linear regression models to investigate the evolution of their mental health as measured by the Kessler 6 (K6) score (range, 0-24; Mean, 3.41; standard deviation, 4.11) during the 5 years after their husbands' retirement.

RESULTS

On average, the wife's K6 score rose by 0.18 (95% confidence interval [CI], 0.08-0.28), 0.18 (95% CI, 0.03-0.34), and 0.19 (95% CI, -0.02 to 0.43) in the first 3 years, respectively, after the husband's retirement, before declining toward the baseline level. However, the wife's active social participation, intense interactions with her husband, and absence of paid employment before her husband's retirement prevented her mental health from deteriorating.

CONCLUSION

The results suggest the limited relevance of the "retired husband syndrome" among middle-aged Japanese couples. The effects of a husband's retirement on the wife's mental health depended heavily on her prior behavior.

The effect of unemployment on the smoking behavior of couples

Although unemployment likely entails various externalities, research examining its spillover effects on spouses is scarce. This is the first paper to estimate effects of unemployment on the smoking behavior of both spouses. Using German Socio-Economic Panel data, we combine matching and difference-in-differences estimation, employing the post-double-selection method for control variable selection via Lasso regressions. One spouse's unemployment increases both spouses' smoking probability and intensity. Smoking relapses and decreased smoking cessation drive the effects. Effects are stronger if the partner already smokes and if the male partner becomes unemployed. Of several mechanisms discussed, we identify smoking to cope with stress as relevant.

Spillover effects of a husband's retirement on a woman's health: Evidence from urban China

Despite an increasing number of studies measuring the effect of retirement on individual well-being, research on spillover effects of one spouse's retirement on another spouse's well-being is limited. If such an effect exists but is not considered, it would result in an underestimation of the total retirement effect. This article examines the effect a man's retirement has on his wife's mental and physical health. Using data from the China Health and Retirement Longitudinal Survey (CHARLS), I exploit the large increase in the probability of retirement at the legal retirement age for urban male wage earners in China as a natural experiment. I implement a fuzzy regression discontinuity design to compare the health outcomes of women whose husbands recently retired with those whose husbands are close to retiring. Findings indicate that the retirement of her spouse improves a woman's physical and mental well-being, most likely by increasing the frequency of her social interactions and exercise.

Health-related quality of life in Switzerland: normative data for the SF-36v2 questionnaire

Purpose

Health-related quality of life (HRQOL) is an important concept to describe well-being of the general population and persons with diseases. The short form-36 (SF-36) is a widely used questionnaire assessing self-reported HRQOL in eight health domains. The aims of this study were to provide normative data for the SF-36 version 2 (SF-36v2) for all language regions in Switzerland and weighting coefficients to calculate two summary measures for physical and mental health.

Methods

A random representative (regarding age, sex, and language region) sample of people living in Switzerland aged 18–75 years in 2015 was eligible for our questionnaire survey. We calculated the eight health domain subscales for different subsamples based on sociodemographic characteristics. Two summary measures for physical and mental health were derived using data-based factor score coefficients and calculated for the subsamples.

Results

A total of 1209 persons completed the SF-36v2 (mean age 48.7 years, 58.1% women). The SF-36v2 was valid and reliable in Switzerland. Physical health was better in men (p = 0.012) and younger persons (p < 0.001). Mental health was better in men (p < 0.001) and older persons (p < 0.001). Regarding regional differences, we found better physical (p = 0.002) and mental (p < 0.001) health in German speaking persons compared to French and Italian speaking persons.

Conclusions

This paper presents the first SF-36v2 normative data for Switzerland, which are based on a recent study in a representative sample. Our normative data and weighting coefficients will enable future studies to compare HRQOL assessed by the SF-36 in healthy and diseased persons to a representative Swiss sample.

Electronic supplementary material

The online version of this article (10.1007/s11136-019-02161-5) contains supplementary material, which is available to authorized users.