Paradigms of retirement: the importance of health and ageing in the Whitehall II study

The Impact of Household Debt on the Health of the Elderly in China: Evidence from China Family Panel Studies

With the aging of China's population and the expansion of household debt, the health of the elderly has become an important social issue. Based on the 2018 China Family Panel Studies (CFPS) database, we explored the impact of household debt on the health of older adults and the mechanism of transmission. The Oprobit and IV-Oprobit models were employed for our analysis. Results: (1) Household debt had a significant negative impact on both the physical and mental health of older adults. (2) Female older adults were more sensitive to the impact of household debt. Additionally, a higher education level led to an increasing impact of debt on mental health, but physical health was only affected in the low-education group. (3) The impact of household debt had an inverted U-shape relationship with household income, indicating that, as household income increases, the impact on health level first rises and then reduces after peaking at a middling level of income. (4) According to the mechanism analysis, household debt affects the health of the elderly by causing them to return to work and reducing their medical expenditures. Considering the above conclusions, we put forward some policy implications to alleviate the health problems of the elderly.

The Longitudinal Association Between Retirement and Depression: A Systematic Review and Meta-Analysis

The purpose of this study was to collect evidence of the relationship between retirement and depression through meta-analysis and further analyze the heterogeneity of results. The quality of the studies was rated based on 10 predefined criteria. We searched for articles published between 1980 and 2020, and a total of 25 longitudinal studies were included in the meta-analysis. The meta-analysis results showed that retirement was associated with more depressive symptoms (d = 0.044, 95% confidence interval (CI): 0.008, 0.080). The association of more depressive symptoms with involuntary retirement (d = 0.180, 95% CI: 0.061, 0.299) was stronger than with voluntary retirement (d = 0.086, 95% CI: -0.018, 0.190) and regulatory retirement (d = 0.009, 95% CI: -0.079, 0.097). Retirement was significantly associated with more depressive symptoms in Eastern developed countries (d = 0.126, 95% CI: 0.041, 0.210), and the association was stronger than that in Western developed countries (d = 0.016, 95% CI: -0.023, 0.055). We found that the transition to retirement was associated with higher risk of depression, and this association varied by the type of retirement and country. Further empirical studies are needed to explore the mechanism of retirement and depression and whether such an association is linked with socioeconomic position.

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.

Retirement and Socioeconomic Differences in Diurnal Cortisol: Longitudinal Evidence From a Cohort of British Civil Servants

Objectives

Early old age and the period around retirement are associated with a widening in socioeconomic inequalities in health. There are few studies that address the stress-biological factors related to this widening. This study examined whether retirement is associated with more advantageous (steeper) diurnal cortisol profiles, and differences in this association by occupational grade.

Method

Data from the 7th (2002–2004), 8th (2006), and 9th (2007–09) phases of the London-based Whitehall II civil servants study were analysed. Thousand hundred and forty three respondents who were employed at phase 8 (mean age 59.9 years) and who had salivary cortisol measured from five samples collected across the day at phases 7 and 9 were analysed.

Results

Retirement was associated with steeper diurnal slopes compared to those who remained in work. Employees in the lowest grades had flatter diurnal cortisol slopes compared to those in the highest grades. Low-grade retirees in particular had flatter diurnal slopes compared to high-grade retirees.

Discussion

Socioeconomic differences in a biomarker associated with stress increase, rather than decrease, around the retirement period. These biological differences associated with transitions into retirement for different occupational groups may partly explain the pattern of widening social inequalities in health in early old age.

A cross-sectional exploratory analysis between pet ownership, sleep, exercise, health and neighbourhood perceptions: the Whitehall II cohort study

BACKGROUND

To explore associations between pets, and specifically dog ownership and sleep, health, exercise and neighbourhood.

METHODS

Cross sectional examination of 6575 participants of the Whitehall II study aged between 59 and 79 years. We used self-assessed measurement scales of the Short Form (SF36), General Health Questionnaire (GHQ), Control, Autonomy, Self-realisation and Pleasure (CASP), Centre for Epidemiologic Studies Depression Scale (CES-D), sleep, exercise, and perceptions of local neighbourhood. In addition the Mini Mental State Examination which is administered to test global cognitive status (MMSE).

RESULTS

We found 2/7 people owned a pet and of those 64% were "very" attached to their pet. Mild exercise in metabolic equivalents (MET-hours) was significantly higher in pet owners than non-owners (median 27.8 (IQR 18.1 to 41.8) vs 25.7 (IQR 16.8 to 38.7), p = 0.0001), and in dog owners than other pets (median 32.3 (IQR 20.8 to 46.1) vs 25.6 (IQR 16.8 to 38.5), p < 0.0001). Moderate exercise was also significantly higher in pet owners than non pet owners (median 11.8 (IQR 4.2 to 21.9) vs 9.8 (IQR 2.8 to 19.5), p < 0.0001), and dog owners than owners of other pets (median 12.3 (IQR 4.2 to 22.2) vs 10.1 (3.1 to 20.0), p = 0.0002) but there were no significant differences with vigorous exercise. We found that pet owners were significantly more positive about their neighbourhood than non-owners on 8/9 questions, while dog owners were (significantly) even more positive than owners of other pets on 8/9 questions. Associations with sleep were mixed, although dog owners had less trouble falling asleep than non-dog owners, with borderline statistical significance.

CONCLUSION

Dog owners feel more positive about their neighbourhood, do more exercise, and fall asleep more easily than non-dog owners. These results suggest that dog owners could be more likely to exercise by walking their dogs and therefore may be more familiar and positive about the area in which they walk their dog.

Older assistant nurses’ motivation for a full or extended working life

The aim of this study was to explore older workers’ motivation for a full or extended working life. With particular focus on assistant nurses aged 55–64 years, working in the elderly care sector. Focus group interviews were conducted with five different groups of assistant nurses. Inductive thematic analysis was used to analyse the interviews and five main themes were developed from the data: ‘Organisational issues’, ‘Health-related problems’, ‘Private issues’, ‘Meaningfulness and appreciation’ and ‘Social support’. Several of the main themes concerned problems with too high work demands of the assistant nurses. These findings suggest that it is important to improve the working conditions of assistant nurses in order to create a more sustainable working life. Increasing the number of staff and improving recovery opportunities and work–life balance could be important steps to improving the working conditions for this group. Finally, upgrading the competency and professionalism of assistant nurses could help to increase the motivation for a full or extended working life.

The effects of exit from work on health across different socioeconomic groups: A systematic literature review

Exit from work leads to different effects on health, partially depending on the socioeconomic status (SES) of people in the work exit. Several studies on the effects of exit from work on health across socioeconomic groups have been performed, but results are conflicting. The aim of this review is to systematically review the available evidence regarding the effects of exit from work on health in high and low socioeconomic groups. A systematic literature search was conducted using Pubmed, Embase, Web of Science, CINAHL and PsycINFO. Search terms related to exit from work, health, SES and design (prospective or retrospective). Articles were included if they focused on: exit from work (early/statutory retirement, unemployment or disability pension); health (general, physical or mental health and/or health behaviour); SES (educational, occupational and/or income level); and inclusion of stratified or interaction analyses to determine differences across socioeconomic groups. This search strategy resulted in 22 studies. For general, physical or mental health and health behaviour, 13 studies found more positive effects of exit from work on health among employees with a higher SES compared to employees with a lower SES. These effects were mainly found after early/statutory retirement. In conclusion, the effects of exit from work, or more specific the effects of early/statutory retirement on health are different across socioeconomic groups. However, the findings of this review should be interpreted with caution as the studies used heterogeneous health outcomes and on each health outcome a limited number of studies was included. Yet, the positive effects of exit from work on health are mainly present in higher socioeconomic groups. Therefore, public health policies should focus on improving health of employees with a lower SES, in particular after exit from work to decrease health inequalities.

Effects of Working Couple's Retirement Sequence on Satisfaction in Patriarchal Culture Country: Probing on Gender Difference

We examined the effects of the differences in the retirement sequence (i.e., who retires first between spouses) on satisfaction in Korea of patriarchal culture. Our empirical study demonstrates that households where men retired first had a much lower satisfaction than households where women retired first. In addition, men were found to show lower satisfaction than wives in both households where women retire first and the households where men retire first. Retirement sequence affecting their satisfaction at the point when only one of the spouses is retired continues to affect their satisfaction after both of them are retired. This means that the difference in the couple's retirement sequence has an ongoing effect on their later happiness. The analysis of the effect of a couple's retirement sequence on the satisfaction in their old life may be useful for improving an individual and couples' quality of life in countries with similar cultures.

Retirement and mental health: dose social participation mitigate the association? A fixed-effects longitudinal analysis

Background

Empirical evidence investigating heterogeneous impact of retirement on mental health depending on social backgrounds is lacking, especially among older adults.

Methods

We examined the impact of changes in working status on changes in mental health using Japanese community-dwelling adults aged ≥65 years participating in the Japan Gerontological Evaluation Study between 2010 and 2013 (N = 62,438). Between-waves changes in working status (“Kept working”, “Retired”, “Started work”, or “Continuously retired”) were used to predict changes in depressive symptoms measured by the Geriatric Depression Scale. First-difference regression models were stratified by gender, controlling for changes in time-varying confounding actors including equivalised household income, marital status, instrumental activities of daily living, incidence of serious illnesses and family caregiving. We then examined the interactions between changes in working status and occupational class, changes in marital status, and post-retirement social participation.

Results

Participants who transitioned to retirement reported significantly increased depressive symptoms (β = 0.33, 95% CI: 0.21–0.45 for men, and β = 0.29, 95% CI: 0.13–0.45 for women) compared to those who kept working. Men who were continuously retired reported increased depressive symptoms (β = 0.13, 95% CI: 0.05–0.20), whereas males who started work reported decreased depressive symptoms (β = −0.20, 95% CI: -0.38–-0.02). Men from lower occupational class (compared to men from higher class) reported more increase in depressive symptoms when continuously retired (β = −0.16, 95% CI: -0.25–-0.08). Those reporting recreational social participation after retirement appeared to be less influenced by transition to retirement.

Conclusions

Retirement may increase depressive symptoms among Japanese older adults, particularly men from lower occupational class backgrounds. Encouraging recreational social participation may mitigate the adverse effects of retirement on mental health of Japanese older men.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-017-4427-0) contains supplementary material, which is available to authorized users.

Age and gender differential relationship between employment status and body mass index among middle-aged and elderly adults: a cross-sectional study

OBJECTIVE

To determine the influence of age and gender, respectively, on the association between employment status and body mass index (BMI) in Korean adults using a large, nationally representative sample.

DESIGN

Cross-sectional study.

SETTING

South Korea.

PARTICIPANTS

7228 from fourth wave of the Korean Longitudinal Study of Aging (KLoSA), the survey's short form and year: 'KLoSA 2012'.

MAIN OUTCOME MEASURES

BMI.

RESULTS

BMI among the employed was higher than among the unemployed for those under 60. In terms of gender, employed men reported higher BMI than their unemployed counterparts, whereas employed women reported lower BMI than did unemployed women.

CONCLUSIONS

Employment status showed varying impacts on obesity by age and gender. Both unemployment at or after 60, as well as unemployment among women, is associated with increased BMI compared with unemployment among younger individuals or men, respectively.

The Impact of Early Retirement on Perceptions of Life at Work and at Home: Qualitative Analyses of British Civil Servants Participating in the Whitehall II Retirement Study

This study examined pathways to retirement and the role of circumstances at work and at home (including the introduction of financially-enhanced early retirement schemes) on retirement-related decision-making. In-depth qualitative interviews were conducted within 2 years of retirement with 59 British civil servants participating in the Whitehall II Study. Focusing on the experiences of 33 interviewees who spontaneously discussed “early retirement” we identified three pathways to retirement (non-applicants, successful applicants, and unsuccessful applicants for early retirement) each influenced by a range of complementary positive and negative factors at work and at home. The early retirement schemes influenced the balance between these factors in three ways: by encouraging participants to reflect on (and reconsider) existing retirement plans; by offering financial incentives to retire early; and because they were part of the ongoing process of restructuring and downsizing within the Civil Service which was accompanied by a perceived deterioration in conditions at work.

Conceptualisation of ageing in relation to factors of importance for extending working life - a review

AIM

The aim of this study was to explore and understand the complexity of ageing in relation to factors of importance for extending working life.

METHOD

Discourse analysis of documents was used in an integrative review including 128 articles.

RESULT

Four different conceptualisation of ageing are shown to affect older workers' ability to extend their working life: (a) biological ageing people's health in relation to their physical and mental work environment, their pace of work and recuperation needs; (b) chronological ageing statutory retirement age and policies and economic incentives devised for older workers by society, unions and organisations/enterprises; (c) social ageing inclusion in different social groups, the attitude of managers, organisations and family members, the leisure activities and surrounding environment; and (d) mental/cognitive ageing self-crediting, motivating and meaningful activities, competence and skills in working life. CONCLUSIONS SOCIETIES TODAY FOCUS MOSTLY ON CHRONOLOGICAL AGEING AND ARE LOOKING TO INCREASE THE RETIREMENT AGE WITH REGARD TO STATUTORY PENSION SYSTEMS, EG BEYOND 65 YEARS OF AGE THE INTER-RELATIONSHIPS BETWEEN CHRONOLOGICAL, MENTAL, BIOLOGICAL AND SOCIAL AGEING AND THE NINE AREAS IDENTIFIED AS BEING IMPORTANT TO OLDER WORKERS IN THESE RESPECTS NEED TO BE CONSIDERED WHEN AIMING TO PROVIDE A SUSTAINABLE WORKING LIFE FOR THE INCREASING NUMBERS OF OLDER WORKERS IN MODERN SOCIETY THE THEORETICAL MODEL DEVELOPED IS A CONTRIBUTION TO THE CRITICAL DEBATE THAT CAN BE APPLIED BY SOCIETIES, EMPLOYERS AND MANAGERS IN ORDER TO PROVIDE OLDER WORKERS WITH AN INCLUSIVE AND SUSTAINABLE EXTENDED WORKING LIFE.

Altruism and participation in longitudinal health research? Insights from the Whitehall II Study

Research that follows people over a period of time (longitudinal or panel studies) is important in understanding the ageing process and changes over time in the lives of older people. Older people may choose to leave studies due to frailty, or illness and this may diminish the value of the study. However, people also drop out of studies for other reasons and understanding the motivation behind participation or drop out may prevent further loss of valuable longitudinal information and assist the continuation of longitudinal studies. This paper examines qualitative data from interviews and focus groups in 2003/2008 with participants of the Whitehall II Study (based at UCL), and investigates reasons participants give for participating in longitudinal health studies, and recommendations they give for encouraging continued participation as they grow older. A total of 28 participants and 14 staff were interviewed, and 17 participants took part in focus groups. Our findings are discussed in the light of the debate between of altruism and reciprocity. Rather than being wholly motivated by altruism, as research staff had assumed, participants were motivated by the benefits they perceived, particularly the information and care received during the medical examinations and the sense of loyalty and membership associated with being part of the study. Our findings support the view that far from being primarily motivated by altruism, research participation in studies such as this may also involve a degree of implicit and explicit reciprocity. However, participants disliked the obligation to complete the study questionnaires--which may have influenced the expectation of payment or reciprocation, as participation was not wholly pleasing. To try and maintain participation in longitudinal health studies this project recommended gathering information from exit interviews as a way of preventing further withdrawals and closer involvement of participants through a user panel.

The Lived Experience of Australian Retirees: ‘I'm Retired, What Do I Do Now?’

Introduction:

The purpose of this qualitative study was to explore the lived experience of retirement in a context where it is not compulsory, and to understand consequent changes in roles, identity and occupational adaptation from the perspective of Australian retirees.

Method:

Five people aged between 61 and 68 years, who had retired during the previous 18 months, were interviewed. Data analysis included transcription and coding of data, data aggregation and identification of themes.

Findings:

The themes that emerged from the data analysis were related to time structure and meaningful occupations, ageing and performance capacity, role changes, emotional adjustment to retirement and preparation for retirement.

Conclusion:

The findings suggest that engagement in meaningful occupations and valued roles, along with the emergence of grandparenting as a significant role, the development of new interests and engagement in retirement planning activities, and support in restructuring the use of time are essential to maintain a positive identity and to adapt successfully to retirement.

Life-Career Re-Engagement: Considerations and Implications for Counselling People in Retirement Transition—Part 2

New ideas and perspectives are needed to form effective counselling strategies and approaches in an effort to promote and enhance the psychological well-being of individuals in retirement transition. This article is the second of two co-published articles. The first, ‘Life- career re-engagement: A new conceptual framework for counselling people in retirement transition’, proposed the new conceptual framework of life-career re-engagement (LCRE) by expanding on the work of Donald Super (1957, 1990). In this second article, counselling considerations that are guided by and supportive of the concept of LCRE are discussed, along with implications for helping intervention. Three essential factors of retirement transition are considered, the importance of contextualising the experiences of retirees is emphasised and issues around identity, personal interests and lifelong learning are explored.

Is retirement good or bad for mental and physical health functioning? Whitehall II longitudinal study of civil servants

BACKGROUND

To determine whether retirement at age 60 is associated with improvement or deterioration in mental and physical health, when analysed by occupational grade and gender.

METHODS

Longitudinal study of civil servants aged 54 to 59 years at baseline, comparing changes in SF-36 health functioning in retired (n=392) and working (n=618) participants at follow up. Data were collected from self completed questionnaires.

RESULTS

Mental health functioning deteriorated among those who continued to work, but improved among the retired. However, improvements in mental health were restricted to those in higher employment grades. Physical functioning declined in both working and retired civil servants.

CONCLUSION

The study found that retirement at age 60 had no effects on physical health functioning and, if anything, was associated with an improvement in mental health, particularly among high socioeconomic status groups.

Work environment and self-rated health as predictors of remaining in work 5 years later among Danish employees 35-59 years of age

In 1990, a random sample of employees (1674 males and 1646 females) in Denmark between 35 and 59 years of age were interviewed about their psychosocial work environment, health, and job satisfaction. In 1995, the cohort was interviewed again regarding present employment status. Predictors from the 1990 interview for remaining in work in 1995 were identified by gender. After controlling for age, very good self-rated health and high development possibilities were found to be independent predictors for remaining in work among males. Among females the predictors were very good self-rated health, high development possibilities, high decision authority, medium level social support and absence of musculoskeletal problems in the knees. In the two extreme 10% risk groups, the "risk" of remaining in work was 58% and 81%, respectively, for males, and 46% and 82% for females.