Academic journal article Scandinavian Journal of Work, Environment & Health

Poor Health, Unhealthy Behaviors, and Unfavorable Work Characteristics Influence Pathways of Exit from Paid Employment among Older Workers in Europe: A Four Year Follow-Up Study

Academic journal article Scandinavian Journal of Work, Environment & Health

Poor Health, Unhealthy Behaviors, and Unfavorable Work Characteristics Influence Pathways of Exit from Paid Employment among Older Workers in Europe: A Four Year Follow-Up Study

Article excerpt

Objectives The aim of this study was to get insight into the role of poor health, unhealthy behaviors, and unfavorable work characteristics on exit from paid employment due to disability pension, unemployment, and early retirement among older workers.

Methods Respondents of the longitudinal Survey of Health, Ageing, and Retirement in Europe (SHARE) in 11 European countries were selected when (i) aged between 50 years and the country-specific retirement age, (ii) in paid employment at baseline, and (iii) having information on employment status during the 4-year follow-up period (N=4923). Self-perceived health, health behaviors, and physical and psychosocial work characteristics were measured by interview at baseline. Employment status was derived from follow-up interviews after two and four years. Cox proportional hazards regression analyses were used to identify determinants of unemployment, disability pension, and early retirement.

Results Poor health was a risk factor for disability pension [hazard ratio (HR) 3.90, 95% confidence interval (95% CI) 2.51-6.05], and a lack of physical activity was a risk factor for disability pension (HR 3.05, 95% CI 1.68-5.55) and unemployment (HR 1.84, 95% CI 1.13-3.01). A lack of job control was a risk factor for disability pension, unemployment, and early retirement (HR 1.30-1.77).

Conclusions Poor health, a lack of physical activity, and a lack of job control played a role in exit from paid employment, but their relative importance differed by pathway of labor force exit. Primary preventive interventions focusing on promoting physical activity as well as increasing job control may contribute to reducing premature exit from paid employment.

Key terms disability pension; early retirement; job control; longitudinal; obesity; physical activity; physical work; self-perceived health; unemployment.

Premature exit from paid employment is a serious concern at both the individual and societal level. On the individual level, exit from paid employment might not only increase the risk of financial and social problems, it might also increase the likelihood of experiencing health problems (1). On the societal level, there is a need to increase work participation and sustain a productive workforce because of decreasing birth rates and increased life expectancy in most industrialized countries (2). Therefore, many countries are developing policies to stimulate labor force participation, particularly to encourage older workers to remain at work longer. In order to develop successful interventions to reduce exit from the labor force, insight into the main determinants of exit from paid employment is needed.

From previous research it is known that poor health plays a role in exit from paid employment, particularly due to disability pension (3-6). Several studies also reported that workers with a poor health are more likely to become unemployed (4, 7-11) and, to a smaller extent, to retire before the statutory retirement age (4, 11,12).

Unhealthy lifestyle behaviors as well as physical and psychosocial work demands might also play a role in exit from paid employment (10). However, the evidence concerning these factors is less consistent. In a cross-sectional analysis, an unhealthy lifestyle was associated with unemployment and early retirement (13). In longitudinal studies, a slightly increased risk of early retirement was found among obese workers and workers with high physical and psychosocial work demands (4, 9, 14). Smoking and obesity have been found to be a determinant of disability pension (6, 15-18). Work-related characteristics underlying Karasek's job demand-control model (19) and Siegrist's effort-reward imbalance model (20) seem to predict exit from paid employment (4).

Determinants of exit from paid employment might differ between the main pathways of leaving the labor force, particularly between the involuntary (ie, disability pension, unemployment) and more voluntary routes (ie, early retirement) of exit from work. …

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