Article Text
Abstract
Objectives Past studies have identified socioeconomic inequalities in the timing and route of labour market exit at older ages. However, few studies have compared these trends cross-nationally and existing evidence focuses on specific institutional outcomes (such as disability pension and sickness absence) in Nordic countries. We examined differences by education level and occupational grade in the risks of work exit and health-related work exit.
Methods Prospective longitudinal data were drawn from seven studies (n=99 164). Participants were in paid work at least once around age 50. Labour market exit was derived based on reductions in working hours, changes in self-reported employment status or from administrative records. Health-related exit was ascertained by receipt of health-related benefit or pension or from the reported reason for stopping work. Cox regression models were estimated for each study, adjusted for baseline self-rated health and birth cohort.
Results There were 50 003 work exits during follow-up, of which an average of 14% (range 2–32%) were health related. Low level education and low occupational grade were associated with increased risks of health-related exit in most studies. Low level education and occupational grade were also associated with an increased risk of any exit from work, although with less consistency across studies.
Conclusions Workers with low socioeconomic position have an increased risk of health-related exit from employment. Policies that extend working life may disadvantage such workers disproportionally, especially where institutional support for those exiting due to poor health is minimal.
- extended working life
- socioeconomic position
- health-related work exit
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Footnotes
Contributors EC, MS, JV and JH planned the study. EC and JH prepared the data and performed the data analysis. MG, DK, MS, JV and MZ advised the analytical strategy. EC wrote the manuscript and all authors revised the manuscript. All authors gave detailed feedback and commented extensively at all stages.
Funding This work was supported by the Medical Research Council and the Economic and Social Research Council under the Lifelong Health and Wellbeing Cross-Council Programme initiative (ES/L002892/1). The MRC National Survey of Health and Development and MS are supported by the UK Medical Research Council (grant numbers MC_UU_12019/1; MC_UU_12019/5). Data used in this publication are available to bona fide researchers upon request to the National Survey of Health and Development (NSHD) Data Sharing Committee via a standard application procedure. Further details can be found at doi:10.5522/NSHD/Q102; doi: 10.5522/NSHD/Q103. The Health and Retirement Study (HRS) is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan. The collection of data in the Whitehall II Study is supported by grants from The UK Medical Research Council (MR/K013351/1; G0902037), British Heart Foundation (RG/13/2/30098) and the US National Institutes of Health (R01HL36310, R01AG013196). RAND HRS Data (Version P) is produced by the RAND Center for the Study of Aging, with funding from the National Institute on Aging and the Social Security Administration. Santa Monica, California (August 2016). The GAZEL cohort study was funded by Électricité de France-Gaz de France(EDF-GDF) and Institut national de la santé et de la recherche médicale (INSERM) and received grants from the ‘Cohortes Santé TGIR Program’, Agence Nationale de la Recherché (ANR; ANR-08-BLAN-0028) and Agence française de sécurité sanitaire de l’environnement et du travail (AFSSET; EST-2008/1/35). SAS was (in part) supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North Thames at Bart’s Health NHS Trust. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health. JV was supported by NordForsk, the Nordic Research Programme on Health and Welfare.
Competing interests None declared.
Patient consent Not required.
Ethics approval Ethical approval was obtained in each of the studies from relevant ethical committees/boards.
Provenance and peer review Not commissioned; externally peer reviewed.