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The impact of ill health on exit from paid employment in Europe among older workers
  1. Tilja van den Berg1,
  2. Merel Schuring1,
  3. Mauricio Avendano1,2,
  4. Johan Mackenbach1,
  5. Alex Burdorf1
  1. 1Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
  2. 2Center for Population and Development Studies, Harvard School of Public Health, Boston, Massachusetts, USA
  1. Correspondence to Alex Burdorf, Department of Public Health, Erasmus MC, PO Box 2040, Rotterdam 3000 CA, the Netherlands; a.burdorf{at}


Objective To determine the impact of ill health on exit from paid employment in Europe among older workers.

Methods Participants of the Survey on Health and Ageing in Europe (SHARE) in 11 European countries in 2004 and 2006 were selected when 50–63 years old and in paid employment at baseline (n=4611). Data were collected on self-rated health, chronic diseases, mobility limitations, obesity, smoking, alcohol use, physical activity and work characteristics. Participants were classified into employed, retired, unemployed and disabled at the end of the 2-year follow-up. Multinomial logistic regression was used to estimate the effect of different measures of ill health on exit from paid employment.

Results During the 2-year follow-up, 17% of employed workers left paid employment, mainly because of early retirement. Controlling for individual and work related characteristics, poor self-perceived health was strongly associated with exit from paid employment due to retirement, unemployment or disability (ORs from 1.32 to 4.24). Adjustment for working conditions and lifestyle reduced the significant associations between ill health and exit from paid employment by 0–18.7%. Low education, obesity, low job control and effort–reward imbalance were associated with measures of ill health, but also risk factors for exit from paid employment after adjustment for ill health.

Conclusion Poor self-perceived health was strongly associated with exit from paid employment among European workers aged 50–63 years. This study suggests that the influence of ill health on exit from paid employment could be lessened by measures targeting obesity, problematic alcohol use, job control and effort–reward balance.

  • Self-perceived health
  • unemployment
  • early-retirement
  • disability
  • mental health
  • ageing
  • disability
  • retired

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  • Funding This paper uses data from release 2 of SHARE 2004 and release 1 of SHARE 2006. The SHARE data collection has been primarily funded by the European Commission through the 5th framework programme (project QLK6-CT-2001-00360 in the thematic programme Quality of Life). Additional funding came from the US National Institute on Ageing (U01 AG09740-13S2, P01 AG005842, P01 AG08291, P30 AG12815, Y1-AG-4553-01 and OGHA 04-064). Data collection in Austria (through the Austrian Science Foundation, FWF), Belgium (through the Belgian Science Policy Office) and Switzerland (through BBW/OFES/UFES) was nationally funded. The SHARE data collection in Israel was funded by the US National Institute on Ageing (R21 AG025169), by the German-Israeli Foundation for Scientific Research and Development (G.I.F.) and by the National Insurance Institute of Israel. Further support by the European Commission through the 6th framework program (projects SHARE-I3, RII-CT-2006-062193, and COMPARE, CIT5-CT-2005-028857) is gratefully acknowledged. Mauricio Avendano is supported by a grant from the Netherlands Organisation for Scientific Research (NWO, grant no. 451-07-001) and a Bell Fellowship from the Harvard Center for Population and Development Studies.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.