The objective was to provide a systematic literature review on associations between poor health and exit from paid employment through disability pension, unemployment and early retirement, and to estimate the magnitude of these associations using meta-analyses. Medline and Embase databases were searched for longitudinal studies on the relationship between health measures and exit from paid employment. Random-effects models were used to estimate the pooled effects. In total, 29 studies were included. Self-perceived poor health was a risk factor for transition into disability pension (relative risk (RR) 4.49; 95% CI 3.09 to 6.52), unemployment (RR 1.54; 95% CI 1.25 to 1.91) and early retirement (RR 1.33; 95% CI 1.14 to 1.54). Workers with mental health problems had an increased likelihood for transition into disability pension (RR 1.82; 95% CI 1.26 to 2.64) or unemployment (RR 1.63; 95% CI 1.21 to 2.22). Chronic disease was a risk factor for transition into disability pension (RR 2.42; 95% CI 2.14 to 2.75) or unemployment (RR 1.31; 95% CI 1.14 to 1.50), but not for early retirement. This meta-analysis showed that poor health, particularly self-perceived health, is a risk factor for exit from paid employment through disability pension, unemployment and, to a lesser extent, early retirement. To increase sustained employability it should be considered to implement workplace interventions that promote good health.
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