1
|
Wang TH, Chien SY, Cheng WJ, Huang YW, Wang SH, Huang WL, Tzeng YL, Hsu CC, Wu CS. Associations of early retirement and mortality risk: a population-based study in Taiwan. J Epidemiol Community Health 2024; 78:522-528. [PMID: 38768983 DOI: 10.1136/jech-2024-222075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/04/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Early retirement is highly prevalent in Taiwan. This study assesses the association between early retirement and all-cause and cause-specific mortality risks while exploring the modifying effect of sociodemographic factors. METHODS Using Taiwan's National Health Insurance Research Database between 2009 and 2019, 1 762 621 early retirees aged 45-64 and an equal number of employed comparators were included. The date and cause of death were identified using the National Death Registry. Cox regression models were used to estimate HRs of early retirement for all-cause mortality and cause-specific mortality. To explore modifying effects, we conducted subgroup analyses based on age groups, sexes, occupation types and general health status (Charlson Comorbid Index score). RESULTS The analysis revealed that early retirees, compared with their concurrently employed counterparts, had a higher mortality risk (adjusted HR (aHR) 1.69, 95% CI (1.67 to 1.71)). Specifically, younger individuals (aged 45-54) (aHR 2.74 (95% CI 2.68 to 2.80)), males (aHR 1.78 (95% CI 1.76 to 1.81)), those in farming or fishing occupations (aHR 2.13 (95% CI 2.06 to 2.21)) or the private sector (aHR 1.92 (95% CI 1.89 to 1.96)), and those with the poorest health conditions (aHR 1.79 (95% CI 1.76 to 1.83)) had higher mortality risks of early retirement. Regarding specific causes of death, the top three highest risks were associated with gastrointestinal disorders, followed by suicide and neurological disorders. CONCLUSIONS This study underscores the substantial mortality risk increase linked to early retirement, emphasising the importance of policy considerations, particularly regarding vulnerable populations and specific causes of death potentially linked to unhealthy lifestyles.
Collapse
Affiliation(s)
- Tsui-Hung Wang
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan
| | - Shao-Yun Chien
- School of Nursing, University of Washington, Seattle, Washington, USA
| | - Wan-Ju Cheng
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Ya-Wen Huang
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan
| | - Shi-Heng Wang
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan
- Department of Medical Research, China Medical University, Taichung, Taiwan
| | - Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital, Douliou, Yunlin, Taiwan
- Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ya-Ling Tzeng
- School of Nursing, China Medical University College of Medicine, Taichung, Taiwan
| | - Chih-Cheng Hsu
- Department of Family Medicine, Min Sheng General Hospital, Taoyuan, Taiwan
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Chi-Shin Wu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Douliou, Yunlin, Taiwan
| |
Collapse
|
2
|
McDonnall MC, Cmar JL. Employment and retirement among workers who develop vision loss in midlife. Work 2024:WOR230669. [PMID: 38640188 DOI: 10.3233/wor-230669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Vision loss increases with age and is thus more likely to happen later in one's career. With more individuals working beyond typical retirement age, the possibility of experiencing vision loss while working has increased. OBJECTIVE The purpose of this study was to investigate how developing vision loss during midlife affects employment and retirement. METHOD Using longitudinal Health and Retirement Study data, we identified a sample of 167 workers, 44 to 64 years old, who developed vision loss and a matched comparison sample of 800 workers who did not. We explored job retention and retirement differences between the groups and differences between people with vision loss who retained jobs versus those who did not. RESULTS Vision loss was associated with leaving the labor force, although there was a clear trend over time of increasing likelihood of job retention. Occupational category was associated with job retention and people who continued working had more favorable financial situations. Retirees with vision loss were more likely to report involuntary retirement and dissatisfaction with retirement. CONCLUSIONS The decreasing likelihood of leaving the labor market after vision loss is an encouraging finding of this study. Workers who left the labor force after vision loss were more likely to be in precarious financial positions, and retirees did not have positive experiences with retirement. Assisting workers with vision loss to remain in the labor force is of vital importance, and increasing awareness and usage of free services for this population may reduce involuntary retirement and its negative consequences.
Collapse
Affiliation(s)
- Michele C McDonnall
- The National Research & Training Center on Blindness & Low Vision, Mississippi State University, USA
| | - Jennifer L Cmar
- The National Research & Training Center on Blindness & Low Vision, Mississippi State University, USA
| |
Collapse
|
3
|
Assari S, Zare H, Sonnega A. Racial Disparities in Occupational Distribution Among Black and White Adults with Similar Educational Levels: Analysis of Middle-Aged and Older Individuals in the Health and Retirement Study. JOURNAL OF REHABILITATION THERAPY 2024; 6:1-11. [PMID: 38774764 PMCID: PMC11108055 DOI: 10.29245/2767-5122/2024/1.1141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
Background Occupational classes play a significant role in influencing both individual and population health, serving as a vital conduit through which higher education can lead to better health outcomes. However, the pathway from education to corresponding occupational classes does not apply uniformly across different racial and ethnic groups, hindered by factors such as social stratification, labor market discrimination, and job segregation. Aims This study seeks to investigate the relationship between educational attainment and occupational classes among Black, Latino, and White middle-aged and older adults, with a focus on their transition into retirement. Methods Using cross-sectional data from the Health and Retirement Study (HRS), this research examines the impact of race/ethnicity, educational attainment, occupational classes, and timing of retirement among middle-aged and older adults. The analysis includes a sample of 7,096 individuals identified as White, Black, or Latino. Through logistic regression, we assess the additive and multiplicative effects of race/ethnicity and education on six defined occupational classes: 1. Managerial and specialty operations, 2. Professional Specialty, 3. Sales, 4. Clerical/administrative support, 5. Services, and 6. Manual labor. Results Participants were Black (n = 1,143) or White (n =5,953). This included Latino (N =459) or non-Latino (n = 6,634). Our analysis reveals a skewed distribution of Black and Latino adults in manual and service occupations, in stark contrast to White adults who were more commonly found in clerical/administrative and managerial positions. Educational attainment did not equate to similar occupational outcomes across racial groups. Key findings include: Firstly, Black individuals with a college degree or higher were less likely to occupy clerical and administrative positions compared to their White counterparts. Secondly, holding a General Educational Development (GED) credential or some college education was generally linked to reduced likelihood of being in managerial roles; however, this inverse relationship was less evident among Black middle-aged and older adults than White ones. Thirdly, having a GED reduced the chances of working in sales roles, while having a college degree increased such chances. An interaction between race and some college education revealed that the impact of some college education on sales roles was more significant for Black adults than for White ones. We did not observe any interaction between ethnicity (Latino) and educational attainment on occupational classes. Given the stability of occupational classes, these findings could also apply to the last occupation held prior to retirement. Conclusion This study highlights significant racial disparities in occupational classes among individuals with comparable levels of education, underscoring the profound implications for health and wellbeing disparities. Future research should explore strategies to alleviate labor market discrimination and job segregation as ways to close these occupational gaps. Additionally, the influence of social stratification, job segregation, and historical legacies, such as the repercussions of the Jim Crow era, on these disparities merits further investigation. Addressing these issues is crucial for enhancing the health and wellbeing of all populations.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- Marginalization-Related-Diminished Returns (MDRs) Center, Los Angeles, CA, USA
| | - Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
- School of Business, University of Maryland Global Campus (UMGC), Adelphi, MD, 20774, USA
| | - Amanda Sonnega
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
4
|
Yang HJ, Cheng Y, Yu TS, Cheng WJ. Association Between Retirement Age and Incidence of Depressive Disorders: A 19-Year Population-Based Study. Am J Geriatr Psychiatry 2024; 32:166-177. [PMID: 37838542 DOI: 10.1016/j.jagp.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE To investigate the occurrence of depressive disorders spanning the transition to retirement, and explore the relationship between retirement age and depressive disorders. METHODS We utilized a national population-based health insurance database encompassing 2 million Taiwanese individuals from 2000 to 2019. The study focused on individuals aged 50 years and older who were employed at the baseline, and 84,224 individuals had records of retirement during the follow-up period. Depressive disorders were identified using codes from the International Classification of Diseases. To assess the trend in the incidence of depressive disorders 7-year period before and after retirement, an interrupted time series analysis was performed. Cox-proportional hazard models were employed to investigate the association between retirement age and the occurrence of depressive disorders following retirement. RESULTS The incidence of depression peaks at the time of retirement and shows a significant decrease after retirement. Incidence of depressive disorders was 6.4 and 7.6 per 1000 person-years among individuals who retired between the ages of 60-64 and 65-69. Comparing the two groups, those who retired between 65 and 69 exhibits a higher risk of developing depressive disorders (hazard ratio = 1.10, 95% confidence interval = 1.02-1.18). This association is particularly pronounced among women and individuals residing in areas with low urbanization levels. CONCLUSION Retirement marks a crucial life milestone accompanied by a peak in depressive disorders. It is important to address the higher risk of depression associated with late retirement among socially disadvantaged groups.
Collapse
Affiliation(s)
- Hang-Ju Yang
- Department of Emergency Medicine (H-JY), Jen Ai Dali Branch, Dali, Taichung, Taiwan
| | - Yawen Cheng
- Institute of Health Policy and Management (YC), College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Teng-Shun Yu
- Management Office for Health Data (T-SY), China Medical University Hospital, Taichung, Taiwan; College of Medicine (T-SY), China Medical University, Taichung, Taiwan
| | - Wan-Ju Cheng
- National Center for Geriatrics and Welfare Research (W-JC), National Health Research Institutes, Miaoli, Taiwan; Department of Psychiatry (W-JC), China Medical University Hospital, Taichung, Taiwan; Department of Public Health (W-JC), China Medical University, Taichung, Taiwan.
| |
Collapse
|
5
|
Voss MW, Richards LG, Price P, Terrill A, Wadsworth L, Hung M. A Mixed-Methods Examination of Lost Occupational Choice in Retirement. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024:15394492231221964. [PMID: 38254302 DOI: 10.1177/15394492231221964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Lost work opportunity and forced retirement demonstrate negative health impacts related to occupational deprivation. Measuring occupational loss during the retirement transition can be problematic. The objective of the study is to clarify measurement of involuntary retirement in its relationship to occupational loss and deprivation. Using an explanatory sequential mixed-methods design, survey data on unemployment, forced retirement, and earlier-than-planned retirement from 195 screened retirees yielded 102 reporting at least one lost work opportunity event, with 18 interviewed about occupational loss within the analytic timeframe. Planned retirement age was similar for full-employment and lost work opportunity groups. Actual retirement age was earlier in the lost work opportunity sample (age 57.5 compared with 61.2). Interviews identified a 22% discrepancy between forced retirement reported in survey versus interview data. Themes emerging from the interviews indicated financial and identity challenges from lost work opportunity, a dialectical trade-off between lost opportunity and daily freedom, and overall resilience.
Collapse
Affiliation(s)
| | | | | | | | | | - Man Hung
- Roseman University of Health Sciences, Salt Lake City, UT, USA
| |
Collapse
|
6
|
Crudden A, McDonnall M, Tatch A. Unable to work? Characteristics of people with blindness and low vision who are out of the labor force. Disabil Health J 2023; 16:101438. [PMID: 36697301 PMCID: PMC10307921 DOI: 10.1016/j.dhjo.2022.101438] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 11/29/2022] [Accepted: 12/23/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Approximately half of the people who are blind or have low vision in the U.S. are not in the labor force, yet we know little about their characteristics or reasons for being out of the labor force. OBJECTIVE/HYPOTHESIS The objective of this study was to compare people with blindness or low vision who reported being unable to work to those out of the labor force for other reasons, unemployed, and employed, and investigate characteristics that differentiate these groups. METHODS Our sample of people with blindness or low vision was selected from the Behavioral Risk Factor Surveillance System to compare people who reported being unable to work to those in other employment groups utilizing multinomial logistic regression. RESULTS The majority of people out of the labor force reported they were unable to work. People unable to work were likely to have low income, more chronic health conditions, days with poor physical health, and functional disabilities than all other groups. They were also more likely to have access to health care than other groups and were more likely to be male and uncoupled compared to those out of the labor force for other reasons. CONCLUSIONS People who reported being unable to work had more chronic health and functional disability issues. Because being out of the labor force puts one at economic risk, further research is indicated to assess policy issues and strategies that might identify employment options that accommodate people with blindness or low vision and additional health issues and disabilities.
Collapse
Affiliation(s)
- Adele Crudden
- National Research and Training Center on Blindness and Low Vision, Mississippi State University, P. O. Box 6189, Miss. State, MS 39762, USA.
| | - Michele McDonnall
- National Research and Training Center on Blindness and Low Vision, Mississippi State University, P. O. Box 6189, Miss. State, MS 39762, USA.
| | - Andrew Tatch
- Department of Anthropology, Sociology, and Criminology, Troy University, 327 MSCX, Troy, AL 36082, USA.
| |
Collapse
|
7
|
Bertman S. The heroic challenge of retirement. J Aging Stud 2022; 63:101080. [PMID: 36462923 DOI: 10.1016/j.jaging.2022.101080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore the theme of retirement in the epic tale of Odysseus and the implications it can have for contemporary retirees in the light of recent empirical research. METHODS Homer's Odyssey (ca. 8th cent. B.C.E.) and Tennyson's poem "Ulysses" (1833) were closely read and compared to disclose the impact retirement had on a literary character who had for most of his life thrived on action. RESULTS While Homer avoided directly describing the quality of Odysseus' life once he had returned home from war, Tennyson focused on it, arguing that a life devoid of adventure would have been intolerable for such a personality. DISCUSSION Seeking out new adventures and experiences, despite one's age, may serve to mitigate one of the most common negative components of retirement today, boredom, and thereby lengthen and enhance the quality of retirees' lives.
Collapse
|
8
|
Diabesity in Elderly Cardiovascular Disease Patients: Mechanisms and Regulators. Int J Mol Sci 2022; 23:ijms23147886. [PMID: 35887234 PMCID: PMC9318065 DOI: 10.3390/ijms23147886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 12/04/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death in the world. In 2019, 550 million people were suffering from CVD and 18 million of them died as a result. Most of them had associated risk factors such as high fasting glucose, which caused 134 million deaths, and obesity, which accounted for 5.02 million deaths. Diabesity, a combination of type 2 diabetes and obesity, contributes to cardiac, metabolic, inflammation and neurohumoral changes that determine cardiac dysfunction (diabesity-related cardiomyopathy). Epicardial adipose tissue (EAT) is distributed around the myocardium, promoting myocardial inflammation and fibrosis, and is associated with an increased risk of heart failure, particularly with preserved systolic function, atrial fibrillation and coronary atherosclerosis. In fact, several hypoglycaemic drugs have demonstrated a volume reduction of EAT and effects on its metabolic and inflammation profile. However, it is necessary to improve knowledge of the diabesity pathophysiologic mechanisms involved in the development and progression of cardiovascular diseases for comprehensive patient management including drugs to optimize glucometabolic control. This review presents the mechanisms of diabesity associated with cardiovascular disease and their therapeutic implications.
Collapse
|
9
|
Mortality and life expectancy trends in Spain by pension income level for male pensioners in the general regime retiring at the statutory age, 2005-2018. Int J Equity Health 2022; 21:96. [PMID: 35836221 PMCID: PMC9281150 DOI: 10.1186/s12939-022-01697-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Research has generally found a significant inverse relationship in mortality risk across socioeconomic (SE) groups. This paper focuses on Spain, a country for which there continues to be very little evidence available concerning retirement pensioners. We draw on the Continuous Sample of Working Lives (CSWL) to investigate disparities in SE mortality among retired men aged 65 and above over the longest possible period covered by this data source: 2005–2018. We use the initial pension income (PI) level as our single indicator of the SE status of the retired population. Methods The mortality gradient by income is quantified in two ways: via an indicator referred to as “relative mortality”, and by estimating changes in total life expectancy (LE) by PI level at ages 65 and 75 over time. We show that, should the information provided by the relative mortality ratio not be completely clear, a second indicator needs to be introduced to give a broad picture of the true extent of inequality in mortality. Results The first indicator reveals that, for the period covered and for all age groups, the differences in death rates across PI levels widens over time. At older age groups, these differences across PI levels diminish. The second indicator shows that disparities in LE at ages 65 and 75 between pensioners in the lowest and highest income groups are relatively small, although slightly higher than previously reported for Spain. This gap in LE widens over time, from 1.49 to 2.54 years and from 0.71 to 1.40 years respectively for pensioners aged 65 and 75. These differences are statistically significant. Conclusions Along with other behavioral and structural aspects, a combination of factors such as the design of the pension system, the universality and quality of the health system, and high levels of family support could explain why LE inequalities for retired Spanish men are relatively small. To establish the reasons for this increased inequality in LE, more research needs to be carried out. An analysis of all Spanish social security records instead of just a sample would provide us with more information.
Collapse
|
10
|
Haapanen MJ, Strandberg TE, Törmäkangas T, von Bonsdorff ME, Strandberg AY, von Bonsdorff MB. Retirement as a predictor of physical functioning trajectories among older businessmen. BMC Geriatr 2022; 22:279. [PMID: 35379176 PMCID: PMC8981673 DOI: 10.1186/s12877-022-03001-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 03/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Associations between retirement characteristics and consequent physical functioning (PF) are poorly understood, particularly in higher socioeconomic groups, where postponing retirement has had both positive and negative implications for PF. METHODS Multiple assessments of PF, the first of which at the mean age of 73.3 years, were performed on 1709 men who were retired business executives and managers, using the RAND-36/SF-36 instrument, between 2000 and 2010. Questionnaire data on retirement age and type of pension was gathered in 2000. Five distinct PF trajectories were created using latent growth mixture modelling. Mortality- and covariate-adjusted multinomial regression models were used to estimate multinomial Odds Ratios (mOR) on the association between retirement characteristics and PF trajectories. RESULTS A one-year increase in retirement age was associated with decreased likelihood of being classified in the 'consistently low' (fully adjusted mOR = 0.82; 95%CI = 0.70, 0.97; P = 0.007), 'intermediate and declining' (mOR = 0.89; 95%CI = 0.83, 0.96; P = 0.002), and 'high and declining' (mOR = 0.92; 95%CI = 0.87, 0.98; P = 0.006) trajectories, relative to the 'intact' PF trajectory. Compared to old age pensioners, disability pensioners were more likely to be classified in the 'consistently low' (mOR = 23.77; 95% CI 2.13, 265.04; P = 0.010), 'intermediate and declining' (mOR = 8.24; 95%CI = 2.58, 26.35; P < 0.001), and 'high and declining' (mOR = 2.71; 95%CI = 1.17, 6.28; P = 0.020) PF trajectories, relative to the 'intact' PF trajectory. CONCLUSIONS Among executives and managers, older age at retirement was associated with better trajectories of PF in old age. Compared to old age pensioners, those transitioning into disability and early old age pensions were at risk of having consistently lower PF in old age.
Collapse
Affiliation(s)
- Markus J Haapanen
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, PO Box 20, FI-00014, Helsinki, Finland. .,Folkhälsan Research Center, Helsinki, Finland. .,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Timo E Strandberg
- Department of Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Timo Törmäkangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Arto Y Strandberg
- Department of Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Mikaela B von Bonsdorff
- Folkhälsan Research Center, Helsinki, Finland.,Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| |
Collapse
|
11
|
Oi K. Would It Kill You to Retire? Testing Short/Long Term/Recurrent Effects of Retirement on All-Cause Mortality Risk. Res Aging 2022; 44:619-638. [PMID: 35195029 DOI: 10.1177/01640275211068151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study traced all-cause mortality risk over the course of retirement and tested whether re-retirement impacts mortality risk differently than the first time. The study differentiated retirement on whether prompted by health (health retirement) or not (non-health retirement). Based on data from 1992 to 2016 Health and Retirement Study (HRS), the sample consists of 7747 women and 7958 men who were working at the baseline. Adjusting for physical health before/after retirement, the discrete-time logit model found increased mortality risk within the first year of non-health retirement only for men, regardless of physical health changes. Re-retirement did not raise mortality risk further. Furthermore, health retirement increased mortality for men and women but substantially less after their surviving the first year. The findings urge future study to explore non-physical pathways of an immediate mortality increase for men in retirement, as well as the monitoring of population trends in health retirement and its antecedents.
Collapse
Affiliation(s)
- Katsuya Oi
- 173219Northern Arizona University, Flagstaff, AZ, USA
| |
Collapse
|
12
|
Yin R, Xin Y, Bhura M, Wang Z, Tang K. Bridge Employment and Longevity: Evidence from a 10-year Follow-up Cohort Study in 0.16 million Chinese. J Gerontol B Psychol Sci Soc Sci 2021; 77:750-758. [PMID: 34718577 DOI: 10.1093/geronb/gbab204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES Bridge employment has been encouraged by many countries worldwide as the societies age rapidly. However, the health impact on bridge employment is not consistent in previous studies. This study aims to explore the association between bridge employment and the long-term health outcome among the Chinese population. METHOD In this prospective cohort study, we used a subset of the China Kadoorie Biobank study, in which 163,619 participants who reached the statutory age of retirement at baseline (2004-2008) were included in this study. Mortality statistics were obtained from death registries in the Death Surveillance Points system annually. We used a Cox proportional hazard model to analyze the association between bridge employment and all-cause mortality. RESULTS Overall, we found that compared to retired/non-employed men and women, hazards of all-cause mortality were lower in older people with bridge employment (Men: 0.82, 95% CI: 0.77-0.88; Women: 0.79, 95% CI: 0.74-0.94) in healthy populations. The protective effect of bridge employment was stronger among older adults living in rural areas and among those from a relatively low socioeconomic status. CONCLUSION The lower risk of all-cause mortality associated with bridge employment was consistently observed among older men and women. Our findings may provide important insights from the health dimension on the retirement policy-making in China as a hyper-ageing society.
Collapse
Affiliation(s)
- Ruoyu Yin
- Vanke School of Public Health, Tsinghua University, Haidian District, Beijing 100084, China.,Department of Public Health and Primary Care, University of Cambridge, United Kingdom
| | - Yiqian Xin
- Vanke School of Public Health, Tsinghua University, Haidian District, Beijing 100084, China.,Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC 27710, United States
| | - Maria Bhura
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Zhicheng Wang
- Vanke School of Public Health, Tsinghua University, Haidian District, Beijing 100084, China
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Haidian District, Beijing 100084, China
| |
Collapse
|
13
|
Pérez-Salamero González JM, Regúlez-Castillo M, Vidal-Meliá C. Differences in Life Expectancy Between Self-Employed Workers and Paid Employees when Retirement Pensioners: Evidence from Spanish Social Security Records. EUROPEAN JOURNAL OF POPULATION-REVUE EUROPEENNE DE DEMOGRAPHIE 2021; 37:697-725. [PMID: 34421450 DOI: 10.1007/s10680-021-09585-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 04/12/2021] [Indexed: 11/30/2022]
Abstract
The aim of this paper is to examine differences in life expectancy (LE) between self-employed (SE) and paid employee (PE) workers when they become retirement pensioners, looking at levels of pension income using administrative data from Spanish social security records. We draw on the Continuous Sample of Working Lives (CSWL) to quantify changes in total life expectancy at age 65 (LE65) among retired men over the longest possible period covered by this data source: 2005-2018. These changes are broken down by pension regime and initial pension income level for three periods. The literature presents mixed evidence, even for the same country-for Japan and Italy, for example-with some studies pointing to higher life expectancy for SE than for PE retirement pensioners while others argue the opposite. In Spain, LE65 is slightly higher for the SE than for PE workers when retirement pensioners. For 2005-2010, a gap in life expectancy of 0.23 years between SE and PE retirement pensioners is observed. This widens to 0.55 years for 2014-2018. A similar trend can be seen if pension income groups are considered. For 2005-2010, the gap in LE65 between pensioners in the lowest and highest income groups is 1.20 years. This widens over time and reaches 1.51 years for 2014-2018. Although these differences are relatively small, they are statistically significant. According to our research, the implications for policy on social security are evident: differences in life expectancy by socioeconomic status and pension regime should be taken into account for a variety of issues involving social security schemes. These include establishing the age of eligibility for retirement pensions and early access to benefits, computing the annuity factors used to determine initial retirement benefits and valuing the liabilities taken on for retirement pensioners.
Collapse
Affiliation(s)
| | - Marta Regúlez-Castillo
- Department of Quantitative Methods, University of the Basque Country (UPV/EHU), Avda Lehendakari Aguirre 84, 48015 Bilbao, Spain
| | - Carlos Vidal-Meliá
- Department of Financial Economics and Actuarial Science, University of Valencia, Avenida de Los Naranjos S.N., 46022 Valencia, Spain.,Instituto Complutense de Análisis Económico, Complutense University of Madrid, Madrid, Spain.,Centre of Excellence in Population Ageing Research (CEPAR), UNSW, Sydney, Australia
| |
Collapse
|
14
|
Han SH. Health consequences of retirement due to non-health reasons or poor health. Soc Sci Med 2021; 273:113767. [PMID: 33609967 PMCID: PMC8021097 DOI: 10.1016/j.socscimed.2021.113767] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/12/2020] [Accepted: 02/07/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES This study aimed to contribute to our understanding of the complex linkage between retirement and health by estimating health consequences of retirement transitions that were not driven by health reasons separately from those caused by poor health, while taking into consideration the health differences that exist between individuals who engage in different labor force behaviors. METHODS Ten waves of rich data from the U.S. Health and Retirement Study (N = 9,347; 52,658 person-wave observations) were used to estimate within-person associations between retirement transitions and subsequent health, assessed with self-rated health and depressive symptoms. To account for the bidirectional relationship between retirement and health, retiree's self-reports of the reasons for labor force withdrawal were used to identify and parse out retirement transitions driven by poor health from the retirement transitions that were unrelated to health reasons. RESULTS Retirement transitions were unrelated to subsequent health if the withdrawal from the labor force was driven by non-health reasons, whereas retirement transitions driven by poor health were associated with worse subsequent health. Retirement transitions that were phased through partial retirement were associated with worse health outcomes compared to transitioning from full-time work to complete retirement. CONCLUSIONS Study findings suggest that retirement policies designed to prolong working lives may be implemented without adversely influencing health of older individuals, and potentially delay negative health outcomes associated with retirement for some segments of the older population for whom labor force participation is considered more valuable.
Collapse
Affiliation(s)
- Sae Hwang Han
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keeton St., Stop A2702, Austin, Texas, 78712-1248, USA; Population Research Center, University of Texas at Austin, 108 E. Dean Keeton St., Stop A2702, Austin, Texas, 78712-1248, USA; Center on Aging and Population Sciences, University of Texas at Austin, 108 E. Dean Keeton St., Stop A2702, Austin, Texas, 78712-1248, USA.
| |
Collapse
|
15
|
Abstract
Although employment can provide older people with both financial and nonfinancial rewards, it is questionable whether those benefits extend to all older workers, particularly those with physically demanding jobs. This study aimed to examine whether the perceived level of physical demands placed on older workers 55 or older is significantly associated with their cognitive function. Using the Health and Retirement Study (HRS) 2010 wave, we analyzed two domains of cognition: verbal episodic memory and reasoning. After controlling for demographics and risk factors for age-related cognitive deterioration, the perceived level of physical demands placed on older workers was still significantly and negatively linked with both memory and reasoning domains of cognition. Older workers with more physically demanding jobs tended to have poorer cognitive function. Further longitudinal studies are needed to confirm this relationship. Supplementary Information The online version contains supplementary material available at 10.1007/s12126-020-09404-8.
Collapse
|
16
|
Ward M, May P, Briggs R, McNicholas T, Normand C, Kenny RA, Nolan A. Linking death registration and survey data: Procedures and cohort profile for The Irish Longitudinal Study on Ageing (TILDA). HRB Open Res 2020; 3:43. [PMID: 32789288 PMCID: PMC7376615 DOI: 10.12688/hrbopenres.13083.2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 01/21/2023] Open
Abstract
Background: Research on mortality at the population level has been severely restricted by an absence of linked death registration and survey data in Ireland. We describe the steps taken to link death registration information with survey data from a nationally representative prospective study of community-dwelling older adults. We also provide a profile of decedents among this cohort and compare mortality rates to population-level mortality data. Finally, we compare the utility of analysing underlying versus contributory causes of death. Methods: Death records were obtained for 779 and linked to individual level survey data from The Irish Longitudinal Study on Ageing (TILDA). Results: Overall, 9.1% of participants died during the nine-year follow-up period and the average age at death was 75.3 years. Neoplasms were identified as the underlying cause of death for 37.0%; 32.9% of deaths were attributable to diseases of the circulatory system; 14.4% due to diseases of the respiratory system; while the remaining 15.8% of deaths occurred due to all other causes. Mortality rates among younger TILDA participants closely aligned with those observed in the population but TILDA mortality rates were slightly lower in the older age groups. Contributory cause of death provides similar estimates as underlying cause when we examined the association between smoking and all-cause and cause-specific mortality. Conclusions: This new data infrastructure provides many opportunities to contribute to our understanding of the social, behavioural, economic, and health antecedents to mortality and to inform public policies aimed at addressing inequalities in mortality and end-of-life care.
Collapse
Affiliation(s)
- Mark Ward
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Peter May
- Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland
| | - Robert Briggs
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Department of Medical Gerontology, St James's Hospital, Dublin, Ireland
| | - Triona McNicholas
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Department of Medical Gerontology, St James's Hospital, Dublin, Ireland
| | - Charles Normand
- Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Department of Medical Gerontology, St James's Hospital, Dublin, Ireland
| | - Anne Nolan
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- The Economic and Social Research Institute, Dublin, Ireland
| |
Collapse
|
17
|
Rankin D, Black M, Flanagan B, Hughes CF, Moore A, Hoey L, Wallace J, Gill C, Carlin P, Molloy AM, Cunningham C, McNulty H. Identifying Key Predictors of Cognitive Dysfunction in Older People Using Supervised Machine Learning Techniques: Observational Study. JMIR Med Inform 2020; 8:e20995. [PMID: 32936084 PMCID: PMC7527918 DOI: 10.2196/20995] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/10/2020] [Accepted: 07/23/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Machine learning techniques, specifically classification algorithms, may be effective to help understand key health, nutritional, and environmental factors associated with cognitive function in aging populations. OBJECTIVE This study aims to use classification techniques to identify the key patient predictors that are considered most important in the classification of poorer cognitive performance, which is an early risk factor for dementia. METHODS Data were used from the Trinity-Ulster and Department of Agriculture study, which included detailed information on sociodemographic, clinical, biochemical, nutritional, and lifestyle factors in 5186 older adults recruited from the Republic of Ireland and Northern Ireland, a proportion of whom (987/5186, 19.03%) were followed up 5-7 years later for reassessment. Cognitive function at both time points was assessed using a battery of tests, including the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), with a score <70 classed as poorer cognitive performance. This study trained 3 classifiers-decision trees, Naïve Bayes, and random forests-to classify the RBANS score and to identify key health, nutritional, and environmental predictors of cognitive performance and cognitive decline over the follow-up period. It assessed their performance, taking note of the variables that were deemed important for the optimized classifiers for their computational diagnostics. RESULTS In the classification of a low RBANS score (<70), our models performed well (F1 score range 0.73-0.93), all highlighting the individual's score from the Timed Up and Go (TUG) test, the age at which the participant stopped education, and whether or not the participant's family reported memory concerns to be of key importance. The classification models performed well in classifying a greater rate of decline in the RBANS score (F1 score range 0.66-0.85), also indicating the TUG score to be of key importance, followed by blood indicators: plasma homocysteine, vitamin B6 biomarker (plasma pyridoxal-5-phosphate), and glycated hemoglobin. CONCLUSIONS The results suggest that it may be possible for a health care professional to make an initial evaluation, with a high level of confidence, of the potential for cognitive dysfunction using only a few short, noninvasive questions, thus providing a quick, efficient, and noninvasive way to help them decide whether or not a patient requires a full cognitive evaluation. This approach has the potential benefits of making time and cost savings for health service providers and avoiding stress created through unnecessary cognitive assessments in low-risk patients.
Collapse
Affiliation(s)
- Debbie Rankin
- School of Computing, Engineering and Intelligent Systems, Ulster University, Derry~Londonderry, United Kingdom
| | - Michaela Black
- School of Computing, Engineering and Intelligent Systems, Ulster University, Derry~Londonderry, United Kingdom
| | - Bronac Flanagan
- School of Computing, Engineering and Intelligent Systems, Ulster University, Derry~Londonderry, United Kingdom
| | - Catherine F Hughes
- School of Biomedical Sciences, Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, United Kingdom
| | - Adrian Moore
- School of Geography and Environmental Sciences, Ulster University, Coleraine, United Kingdom
| | - Leane Hoey
- School of Biomedical Sciences, Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, United Kingdom
| | - Jonathan Wallace
- School of Computing, Ulster University, Jordanstown, United Kingdom
| | - Chris Gill
- School of Biomedical Sciences, Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, United Kingdom
| | - Paul Carlin
- School of Health, Wellbeing and Social Care, The Open University, Belfast, United Kingdom
| | - Anne M Molloy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Conal Cunningham
- Mercers Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Helene McNulty
- School of Biomedical Sciences, Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, United Kingdom
| |
Collapse
|
18
|
Kim ES, Chen Y, Kawachi I, VanderWeele TJ. Perceived neighborhood social cohesion and subsequent health and well-being in older adults: An outcome-wide longitudinal approach. Health Place 2020; 66:102420. [PMID: 32905980 DOI: 10.1016/j.healthplace.2020.102420] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 07/07/2020] [Accepted: 08/11/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Growing research documents associations between neighborhood social cohesion with better health and well-being. However, other work has identified social cohesion's "dark side" and its ability to promote negative outcomes. It remains unclear if such diverging findings are attributable to differences in study design, or other reasons. To better capture its potential heterogeneous effects, we took an outcome-wide analytic approach to examine perceived neighborhood social cohesion in relation to a range of health and well-being outcomes. METHODS Data were from 12,998 participants in the Health and Retirement Study-a large, diverse, prospective, and nationally representative cohort of U.S. adults age >50. Multiple regression models evaluated if social cohesion was associated with physical health, health behavior, psychological well-being, psychological distress, and social well-being outcomes. All models adjusted for sociodemographics, personality, and numerous baseline health and well-being characteristics. To evaluate the effects of change in cohesion, we adjusted for prior social cohesion. Bonferroni correction was used to account for multiple testing. RESULTS Perceived neighborhood social cohesion was not associated with most physical health outcomes (except for reduced risk of physical functioning limitations and better self-rated health) nor health behavior outcomes (except for more binge drinking). However, it was associated with numerous subsequent psychosocial well-being (i.e., higher: positive affect, life satisfaction, optimism, purpose in life, mastery, health mastery, financial mastery; reduced likelihood of infrequent contact with friends) and psychological distress outcomes (i.e., lower depression, hopelessness, negative affect, loneliness) over the 4-year follow-up period. CONCLUSIONS With further research, these results suggest that perceived neighborhood social cohesion might be a valuable target for innovative policies aimed at improving well-being.
Collapse
Affiliation(s)
- Eric S Kim
- Department of Psychology, University of British Columbia, Vancouver, Canada; Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA.
| | - Ying Chen
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ichiro Kawachi
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tyler J VanderWeele
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
19
|
Ward M, May P, Briggs R, McNicholas T, Normand C, Kenny RA, Nolan A. Linking death registration and survey data: Procedures and cohort profile for The Irish Longitudinal Study on Ageing. HRB Open Res 2020; 3:43. [PMID: 32789288 PMCID: PMC7376615 DOI: 10.12688/hrbopenres.13083.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2020] [Indexed: 03/31/2024] Open
Abstract
Background: Research on mortality at the population level has been severely restricted by an absence of linked death registration and survey data in Ireland. We describe the steps taken to link death registration information with survey data from a nationally representative prospective study of community-dwelling older adults. We also provide a profile of decedents among this cohort and compare mortality rates to population-level mortality data. Finally, we compare the utility of analysing underlying versus contributory causes of death. Methods: Death records were obtained for 779 (90.3% of all confirmed deaths at that time) and linked to individual level survey data from The Irish Longitudinal Study on Ageing (TILDA). Results: Overall, 9.1% of participants died during the nine-year follow-up period and the average age at death was 75.3 years. Neoplasms were identified as the underlying cause of death for 37.0%; 32.9% of deaths were attributable to diseases of the circulatory system; 14.4% due to diseases of the respiratory system; while the remaining 15.8% of deaths occurred due to all other causes. Mortality rates among younger TILDA participants closely aligned with those observed in the population but TILDA mortality rates were slightly lower in the older age groups. Contributory cause of death provides similar estimates as underlying cause when we examined the association between smoking and all-cause and cause-specific mortality. Conclusions: This new data infrastructure provides many opportunities to contribute to our understanding of the social, behavioural, economic, and health antecedents to mortality and to inform public policies aimed at addressing inequalities in mortality and end-of-life care.
Collapse
Affiliation(s)
- Mark Ward
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Peter May
- Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland
| | - Robert Briggs
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Department of Medical Gerontology, St James's Hospital, Dublin, Ireland
| | - Triona McNicholas
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Department of Medical Gerontology, St James's Hospital, Dublin, Ireland
| | - Charles Normand
- Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Department of Medical Gerontology, St James's Hospital, Dublin, Ireland
| | - Anne Nolan
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- The Economic and Social Research Institute, Dublin, Ireland
| |
Collapse
|
20
|
Martin CJ, Jin C, Bertke SJ, Yiin JH, Pinkerton LE. Increased overall and cause-specific mortality associated with disability among workers' compensation claimants with low back injuries. Am J Ind Med 2020; 63:209-217. [PMID: 31833089 PMCID: PMC9969356 DOI: 10.1002/ajim.23083] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/27/2019] [Accepted: 12/02/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND Mortality tends to be higher among people who do not work than among workers, but the impact of work-related disability on mortality has not been well studied. METHODS The vital status through 2015 was ascertained for 14 219 workers with an accepted workers' compensation claim in West Virginia for a low back injury in 1998 or 1999. Mortality among the cohort compared with the West Virginia general population was assessed using standard life table techniques. Associations of mortality and disability-related factors within the cohort were evaluated using Cox proportional hazards regression. RESULTS Compared to the general population, mortality from accidental poisoning was significantly elevated among the overall cohort and lost-time claimants. Most deaths from accidental poisoning in the cohort were due to drug overdoses involving opioids. Mortality from intentional self-harm was also significantly elevated among lost-time claimants. In internal analyses, overall mortality and mortality from cancer, heart disease, intentional self-harm, and drug overdoses involving opioids was significantly associated with lost time. Overall mortality and mortality from drug overdoses involving opioids were also significantly associated with amount of lost time, permanent partial disability, and percent permanent disability. Heart disease mortality was also significantly associated with the amount of lost time. CONCLUSIONS The results suggest that disability itself may impact mortality risks. If confirmed, these results reinforce the importance of return to work and other efforts to reduce disability.
Collapse
Affiliation(s)
- Christopher J. Martin
- Department of Occupational and Environmental Health Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia
| | - ChuanFang Jin
- Department of Occupational and Environmental Health Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia
| | - Stephen J. Bertke
- Field Research Branch, Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - James H. Yiin
- Field Research Branch, Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - Lynne E. Pinkerton
- Field Research Branch, Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, Ohio,Attain, LLC, McLean, Virginia
| |
Collapse
|
21
|
Sewdas R, de Wind A, Stenholm S, Coenen P, Louwerse I, Boot C, van der Beek A. Association between retirement and mortality: working longer, living longer? A systematic review and meta-analysis. J Epidemiol Community Health 2020; 74:473-480. [PMID: 32079605 PMCID: PMC7307664 DOI: 10.1136/jech-2019-213023] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 01/03/2020] [Accepted: 01/26/2020] [Indexed: 11/16/2022]
Abstract
Aim This study summarised available evidence on the association between early and on-time retirement, compared with continued working, and mortality. Moreover, this study investigated whether and to what extent gender, adjustment for demographics and prior health status influence this association. Methods A systematic literature search of longitudinal studies was conducted. A qualitative analysis of the included studies was performed, followed by a meta-regression analysis to assess the influence of gender, prior health and demographics. Random-effects models were used in a meta-analysis to estimate the pooled effects for relevant subgroups identified in the meta-regression. Results In total, 25 studies were included. Adjustment for prior health and demographics influenced the association between retirement and mortality (p<0.05). The results of the meta-analysis of 12 studies are presented for ‘insufficiently adjusted’ and ‘fully adjusted’ subgroups. There was no association between early retirement and mortality compared with working until retirement (fully adjusted subgroup: HR 1.05, 95% CI 0.87 to 1.28). On-time retirement was associated with a higher risk of mortality compared with working beyond retirement (insufficiently adjusted subgroup: HR 1.56, 95% CI 1.41 to 1.73). However, in the subgroup that adjusted for prior health, on-time retirement was not associated with mortality (HR 1.12, 95% CI 0.98 to 1.28). Conclusion Early retirement was not associated with a higher risk of mortality. On-time retirement was associated with a higher risk of mortality, which might reflect the healthy worker effect. It is important to consider information on prior health and demographics when studying the association between retirement and mortality to avoid biased findings.
Collapse
Affiliation(s)
- Ranu Sewdas
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC - Locatie VUMC, Amsterdam, Noord-Holland, The Netherlands
| | - Astrid de Wind
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC - Locatie VUMC, Amsterdam, Noord-Holland, The Netherlands.,Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC - Locatie AMC, Amsterdam, North Holland, The Netherlands.,Behavioural Science Institute, Radboud Universiteit, Nijmegen, Gelderland, The Netherlands
| | - Sari Stenholm
- Department of Public Health, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC - Locatie VUMC, Amsterdam, Noord-Holland, The Netherlands
| | - Ilse Louwerse
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC - Locatie VUMC, Amsterdam, Noord-Holland, The Netherlands
| | - Cécile Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC - Locatie VUMC, Amsterdam, Noord-Holland, The Netherlands
| | - Allard van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC - Locatie VUMC, Amsterdam, Noord-Holland, The Netherlands
| |
Collapse
|
22
|
Nie J, Wang J, Aune D, Huang W, Xiao D, Wang Y, Chen X. Association between employment status and risk of all-cause and cause-specific mortality: a population-based prospective cohort study. J Epidemiol Community Health 2020; 74:428-436. [DOI: 10.1136/jech-2019-213179] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 01/08/2020] [Accepted: 02/03/2020] [Indexed: 12/25/2022]
Abstract
BackgroundUnemployment has been reported to be associated with an increased risk of mortality. While most available studies focused on the effects of temporary unemployment on mortality, it remains unclear whether similar trends can be found in subjects who were never employed or are retirement. Therefore, this study examined the associations between temporary unemployment, never employed and retirement, integrating the risk of all-cause and cause-specific mortality in US adults.MethodsData from the National Health Interview Survey from 2001 to 2013 Linked Mortality files through 31 December 2015 were used. A total of 282 364 participants aged 18 to 65 years were included. Their employment status was categorised into four groups: employed, never employed, temporary unemployed and retired.ResultsDuring the mean follow-up time of 8.2 years, 12 645 subjects died from a variety of causes. Compared with employed participants, temporary unemployed, never employed or retired participants faced an increased risk of mortality for all-cause (temporary unemployed HR 1.76, 95% CI 1.67 to 1.86; never employed HR 1.63, 95% CI 1.47 to 1.81; retired HR 1.27, 95% CI 1.17 to 1.37). Cause-specific mortality analysis showed that compared with employed participants, temporary unemployed or never employed participants faced a significantly increased risk of mortality from cancer, cardiovascular disease, chronic lower respiratory disease, diabetes and kidney disease.ConclusionThis study showed that retired, temporary unemployed and never employed participants aged 18 to 65 years were strongly associated with higher mortality, indicating that both temporary and long-term unemployment are associated with a higher risk of mortality and adversely affect longevity.
Collapse
|
23
|
Voss MW, Al Snih S, Li W, Hung M, Richards LG. Boundaries of the Construct of Unemployment in the Preretirement Years: Exploring an Expanded Measurement of Lost-Work Opportunity. WORK, AGING AND RETIREMENT 2020; 6:59-63. [PMID: 31949916 PMCID: PMC6947921 DOI: 10.1093/workar/waz006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
There is uncertainty related to whether retirement negatively affects health-possibly due to complexity around retirement decisions. Lost-work opportunity through unemployment or forced retirement has been shown to negatively affect health. Lost-work opportunity can be captured in two measurement fields, either a reported experience of being forced into retirement or reported unemployment. However, 17% of individuals retiring due to the loss of work opportunity identified in qualitative interviewing (i.e., unemployment, temporary lay-offs, company buy-outs, forced relocations, etc.) do not report this unemployment or involuntary retirement in quantitative survey responses. We propose broadening the conceptualization of late-career unemployment to incorporate other lost work opportunity scenarios. Using the Health and Retirement Study (HRS), a lost-work opportunity score (LOS) was computed from items indicating unemployment and forced or unplanned retirement. Correlations were computed between this LOS and all continuous variables in the RAND longitudinal compilation of the HRS to determine its convergent and discriminant validity. The LOS demonstrated a Chronbach's alpha of α = .82 and had convergent validity with constructs of employment (9 variables), finances (36 variables), and health (14 variables), as predicted by the literature on retirement timing. No other continuous variables in the HRS were identified with a moderate or strong correlation to LOS, demonstrating discriminant validity. Further research should explore whether a combination of variables in the HRS can improve the accuracy of measuring lost-work opportunity. Improved precision in measurement, through an expanded conceptualization of lost-work opportunity, may help explicate the retirement-related factors that affect health, to inform policy and support healthy aging decisions at a societal level.
Collapse
Affiliation(s)
- Maren Wright Voss
- Health and Wellness Extension, Utah State University, Logan, Utah, USA
- College of Health, Division of Rehabilitation Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Soham Al Snih
- Division of Rehabilitation Sciences, University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Wei Li
- Department of Family and Preventative Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Man Hung
- Roseman University of Health Sciences, College of Dental Medicine, South Jordan, Utah, USA
| | - Lorie Gage Richards
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
24
|
Sakurai M, Ishizaki M, Miura K, Nakashima M, Morikawa Y, Kido T, Naruse Y, Nogawa K, Suwazono Y, Nogawa K, Nakagawa H. Health status of workers approximately 60 years of age and the risk of early death after compulsory retirement: A cohort study. J Occup Health 2019; 62:e12088. [PMID: 31560151 PMCID: PMC6970400 DOI: 10.1002/1348-9585.12088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 08/02/2019] [Accepted: 09/11/2019] [Indexed: 12/02/2022] Open
Abstract
Objectives The increasing number of working elderly people has enhanced the importance of workplace health promotion activities. We investigated the association between the health status of workers approximately 60 years of age and the risk of all‐cause mortality after compulsory retirement in Japan. Methods The 2026 participants (1299 males and 727 females) had retired from a metal‐products factory at ≥60 years of age. Baseline health examinations were conducted at 60 years of age and included questions about medical history and lifestyle factors; the participants also underwent a physical examination. The participants were followed up annually by mail for an average of 7.4 years. The association between health status at age 60 years and the risk of all‐cause mortality was assessed by Cox proportional hazards regression analysis. Results During the study, 71 deaths were reported. The age‐ and sex‐adjusted hazard ratio (HR [95% confidence interval]) for all‐cause mortality was higher for males (HR, 3.41 [1.73‐6.69]) compared with females, participants with a low body mass index (<18.5 kg/m2; HR 3.84 [1.91‐7.73]) compared with normal body weight, smokers (HR, 2.63 [1.51‐4.58]) compared with nonsmokers, and those with three or more of four metabolic abnormalities (obesity, high blood pressure, dyslipidemia, and glucose intolerance) (HR 2.29 [1.04‐5.02]) compared with no metabolic abnormalities. The associations were unaffected by adjustment for these factors. Conclusion Maintenance of an appropriate body weight, smoking cessation, and elimination of metabolic syndrome are required for older workers to prevent early death after retirement.
Collapse
Affiliation(s)
- Masaru Sakurai
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada, Japan.,Health Evaluation Center, Kanazawa Medical University, Uchinada, Japan
| | - Masao Ishizaki
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada, Japan.,Health Evaluation Center, Kanazawa Medical University, Uchinada, Japan
| | - Katsuyuki Miura
- Department of Health Science, Shiga University of Medical Science, Otsu, Japan
| | - Motoko Nakashima
- Department of Nursing, Faculty of Health Sciences, Komatsu University, Komastsu, Japan
| | - Yuko Morikawa
- School of Nursing, Kanazawa Medical University, Uchinada, Japan
| | - Teruhiko Kido
- School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | | | - Kazuhiro Nogawa
- Department of Occupation and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasushi Suwazono
- Department of Occupation and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Koji Nogawa
- Department of Occupation and Environmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hideaki Nakagawa
- Medical Research Institute, Kanazawa Medical University, Uchinada, Japan
| |
Collapse
|
25
|
Tanaka H, Miyawaki A, Toyokawa S, Kobayashi Y. Relationship of relative poverty and social relationship on mortality around retirement: a 10-year follow-up of the Komo-Ise cohort. Environ Health Prev Med 2018; 23:64. [PMID: 30579355 PMCID: PMC6303926 DOI: 10.1186/s12199-018-0756-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/11/2018] [Indexed: 11/25/2022] Open
Abstract
Background As society is aging, retirement takes on increasing importance for individuals in the later life. This study aimed to describe mortality before and after retirement in the Japanese middle-aged/elderly with special attention to socioeconomic position and social relationships. Methods We conducted a 10-year follow-up study (the Komo-Ise cohort study) and assessed mortality according to socioeconomic positions (relative poverty and occupation) and social relationships (e.g., marital status, living alone, and social support) in workers and the retired. Relative poverty was defined as a household equivalent income of 12,700 US dollars (1.37 million Japanese Yen) or less in 2000. Stratified analyses were conducted according to sex in two groups of employment status: the workers and the retired. Adjusted hazard ratios (HRs) were calculated using the Cox proportional hazard model. Results We included 5534 individuals. Of these, 3360 were men (working, 2499; retired, 861) and 2174 were women (working, 1306; retired, 868). We observed 610 deaths (475 in men and 135 in women) during the study period. Relative poverty was a significant risk factor for death (HR 1.52, 95% confidence interval [CI] 1.07–2.14) among retired men but not among working men (HR 1.20, 95% CI 0.79–1.83). Among workers, self-employed men showed a significantly higher hazard of death (HR 1.57, 95% CI 1.09–2.25) than white-collar employees. Retired men who lacked participation in social activities were more likely to die than those who did not (HR 1.44, 95% CI 1.06–1.94). All results, except marital status, indicated non-significant associations in women. Conclusions Relative poverty and lack of social engagement may be related to high mortality risk in retired men. Further studies are needed to assess the health status among the middle-aged/elderly population around retirement.
Collapse
Affiliation(s)
- Hirokazu Tanaka
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Atsushi Miyawaki
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Satoshi Toyokawa
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| |
Collapse
|
26
|
Involuntary and Delayed Retirement as a Possible Health Risk for Lower Educated Retirees. JOURNAL OF POPULATION AGEING 2018. [DOI: 10.1007/s12062-018-9234-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
27
|
Voss MW, Wadsworth LL, Birmingham W, Merryman MB, Crabtree L, Subasic K, Hung M. Health Effects of Late-Career Unemployment. J Aging Health 2018; 32:106-116. [PMID: 30338714 DOI: 10.1177/0898264318806792] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective: Job loss has a demonstrated negative impact on physical and mental health. Involuntary retirement has also been linked to poorer physical and mental health outcomes. This study examined whether late-career unemployment is related to involuntary retirement and health declines postretirement. Method: Analysis was conducted using the 2000-2012 U.S. Health and Retirement Study (HRS) survey data with unemployment months regressed with demographic and baseline health measures on physical and mental health. Results: Individuals with late-career unemployment reported more involuntary retirement timing (47.0%) compared with those reporting no unemployment (27.9%). Late-career unemployment had no significant effect on self-reported physical health (β = .003, p = .84), but was significantly associated with lower levels of mental health (β = .039; p < .01). Conclusion: Self-reports of late-career unemployment are not associated with physical health in retirement, but unemployment is associated with involuntary retirement timing and mental health declines in retirement. Unemployment late in the working career should be addressed as a public mental health concern.
Collapse
Affiliation(s)
- Maren Wright Voss
- Utah State University, Logan, UT, USA.,Towson University, Towson, MD, USA
| | | | | | | | | | | | - Man Hung
- The University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
28
|
Dong XS, Wang X, Ringen K, Sokas R. Baby boomers in the United States: Factors associated with working longer and delaying retirement. Am J Ind Med 2017; 60:315-328. [PMID: 28299821 DOI: 10.1002/ajim.22694] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVES This study estimated the self-reported probability of working full-time past age 62 (P62) or age 65 (P65) among four cohorts of Americans born between 1931 and 1959. METHODS Data from the Health and Retirement Study (HRS) were analyzed. Respondents in four age cohorts were selected for comparison. Multivariable linear regression models were used to assess cohort differences in P62 and P65 while adjusting for covariates. RESULTS P62 and P65 increased among boomers despite worsened self-rated health compared to the two preceding cohorts, with 37% and 80% increases among mid-boomers in construction trades. Cohort differences in P62 and P65 remained after controlling for covariates. Changes in pensions, income inequity, and education were significantly associated with work expectations, but SSA policy was not. CONCLUSIONS Baby boomers expect to work longer than their predecessors. Efforts to improve work quality and availability for older workers are urgently needed, particularly in physically demanding occupations. Am. J. Ind. Med. 60:315-328, 2017. © 2017 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Xiuwen Sue Dong
- CPWR-The Center for Construction Research and Training; Silver Spring Maryland
| | - Xuanwen Wang
- CPWR-The Center for Construction Research and Training; Silver Spring Maryland
| | - Knut Ringen
- CPWR-The Center for Construction Research and Training; Silver Spring Maryland
- Stoneturn Consultants; Seattle Washington
| | - Rosemary Sokas
- Department of Human Science; Georgetown University School of Nursing and Health Studies; Washington District of Columbia
| |
Collapse
|
29
|
Steffens NK, Jetten J, Haslam C, Cruwys T, Haslam SA. Multiple Social Identities Enhance Health Post-Retirement Because They Are a Basis for Giving Social Support. Front Psychol 2016; 7:1519. [PMID: 27799916 PMCID: PMC5065989 DOI: 10.3389/fpsyg.2016.01519] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 09/20/2016] [Indexed: 11/13/2022] Open
Abstract
We examine the extent to which multiple social identities are associated with enhanced health and well-being in retirement because they provide a basis for giving and receiving social support. Results from a cross-sectional study show that retirees (N = 171) who had multiple social identities following (but not prior to) retirement report being (a) more satisfied with retirement, (b) in better health, and (c) more satisfied with life in general. Furthermore, mediation analyses revealed an indirect path from multiple social identities to greater satisfaction with retirement and better health through greater provision, but not receipt, of social support to others. These findings are the first to point to the value of multiple group membership post-retirement as a basis for increased opportunities to give meaningful support to others. We discuss the theoretical and practical implications for the management of multiple identities in the process of significant life transitions such as retirement.
Collapse
Affiliation(s)
- Niklas K Steffens
- School of Psychology, The University of Queensland Brisbane, QLD, Australia
| | - Jolanda Jetten
- School of Psychology, The University of Queensland Brisbane, QLD, Australia
| | - Catherine Haslam
- School of Psychology, The University of Queensland Brisbane, QLD, Australia
| | - Tegan Cruwys
- School of Psychology, The University of Queensland Brisbane, QLD, Australia
| | - S Alexander Haslam
- School of Psychology, The University of Queensland Brisbane, QLD, Australia
| |
Collapse
|