Background The relationship between job insecurity, chronic health conditions (CHCs), and retirement among older workers are likely to differ between countries that have different labor markets and health and social safety nets. To date, there are no epidemiological studies that have prospectively assessed the role of job insecurity in retirement incidence, while accounting for CHCs in two countries with vastly different welfare systems. We investigated the strength of the association baseline job insecurity and retirement incidence over an 11-year period while accounting for CHCs, among workers aged 50 and above in the UK and U.S.

Methods We performed Cox proportional hazards regression analysis, using data from the Health and Retirement Study (HRS [U.S. cohort, n=491]) and English Longitudinal Study on Aging (ELSA [UK cohort n=821]).

Results We found evidence of reduced likelihood of retirement among job insecure adults in both cohorts, and a significant association between CHCs and retirement in the U.S cohort only. In the UK cohort, the association between job insecurity and decreased retirement incidence (HR=0.69, 95% CI =0.50–0.95) was attenuated after adjustment for CHCs and covariates. In the U.S cohort, adjustment for CHCs and other social and health factors significantly decreased this association (HR=0.60, 95%CI = 0.36–0.99), indicating that CHCs, social, and health factors are contributing mechanistic factors underpinning retirement incidence in the U.S.

Conclusions The country level differences we observed may be driven by macro level factors operating latently, which may affect the work environment, health outcomes, and retirement decisions uniquely in different settings.