Healthy pensioners: Is working in our 60s good for us?

Pension ages in the UK are rising from the traditional 65 for men and 60 for women, as people live longer. But is working in later life good for us? The Government’s Chief Medical Officer Professor Dame Sally Davies says people aged 50-70 are more likely to stay healthy if they stay in work, but what does the evidence show? Dr Giorgio Di Gessa from the London School of Economics and Political Science and colleagues have investigated how being in paid work beyond state pension age affects our physical and mental health and how well we sleep and find a different story.

By 2020, it is estimated that one third of workers will be over 50. By then the state pension age will also have risen to 66 for everyone in the UK, climbing to 67 by 2028.

Figures from the Office for National Statistics reveal more than 1.2 million over-65s remain in work, an increase of nearly 50 per cent since the Default Retirement Age was banned in 2011, meaning employers cannot make staff retire when they reach state pension age.

With so many older people working, and with UK policies, and those of other western nations, designed to extend working lives, it is important to understand how continuing to work might affect our health.

Many studies have shown that working is good for physical and mental health in adults of normal working age. There is also evidence that retirement can be good for health. But little research has focused on the impact on health of working beyond State Pension age.

A previous study using the British Household Panel Survey suggests those working beyond state pension age self-report better health, but their lifetime health history was not studied. Given that healthier people are more likely to stay working, this needs to be taken into account for a more accurate picture.

Previous work history is also important, as there is evidence of poorer health among those with significant periods out of work. This is also likely to affect decisions about whether to continue working in later life.

Working longer

Using information on more than 1,600 people from the English Longitudinal Study of Ageing, we looked at the health and employment histories of men aged 65 to 74, and women aged 60 to 69. After those ages few men or women worked. Around a quarter of the women and 15 per cent of the men worked past State Pension age.

Participants in the study were asked if they had difficulties falling or staying asleep and whether they felt tired on waking up. Their grip strength was measured, and they also rated their own health, reporting any medical problems such as a long standing illness, heart disease, stroke, or loss of mobility.

For those who were employed, we looked at whether they worked more or less than 20 hours each week, and whether they had sedentary or active jobs. We also looked for differences between those in managerial and professional occupations through to those with routine and manual jobs.

Periods of unemployment for men and part-time working and career breaks for women were taken into account, together with the individual’s education, wealth, housing situation, marital status, caring responsibilities and factors like smoking and exercising.

Good health

Men and women in good health were more likely to be working past state pension age, as were those with a better education and those who had been in better health throughout their lives . Among women, those who were divorced or separated, still had mortgages and were not carers were more likely to continue working.

One third of those working beyond state pension age were in managerial positions, 45 per cent worked part-time, and one third of men and 41 per cent of women had a desk job. Men and women who worked throughout their lives were more likely to continue working after state pension age.

Men and women in paid work were less likely to be depressed or to have disturbed sleep, and reported better physical health, than those who didn’t work.

However, when social background, and previous health and employment histories were taken into account, we did not find any significant health benefits of working past state pension age. This is most likely to be because only a select group of healthy older adults work beyond this age.

Population health

What is clear is that the decision and ability to continue working past state pension age is strongly affected by current and lifetime health.

Overall, our study shows that extending our working lives has no effect on our health. However, it remains an open question whether changing the state pension age could worsen population health if everyone, including those in poor health, is required to work longer.

To support policies aimed at extending working lives, it will be essential for governments to focus on health promotion and policies which help to improve the health of the population throughout their working life.

Going forward it would be useful to know more about the reasons people continue working. Is it through choice or because they need the money? It would also be good to look at the timing of previous poor health to see at what stage ill health stops people from working.

Further information

Is being in paid work beyond state pension age beneficial for health? Evidence from England using a life-course approach is research by Giorgio Di Gessa of the London School of Economics and Political Science, Laurie Corna of King’s College London, Loretta Platts of Stockholm University, Diana Worts and Peggy McDonough of the University of Toronto, Amanda Sacker of University College London, Debora Price of the University of Manchester, and Karen Glaser of King’s College London. It is published in the Journal of Epidemiology & Community Health.

Photo credit: Farmer stepping into cab, United Soybean

Work and family conflict: who is at risk?

Juggling the demands of work and family can create conflict and this can play out differently for men and women. But what other factors are at play? Do things like the sort of job we do and the levels of control we feel we have at work and at home matter too? It’s a subject of keen interest not just to individuals, but also employers and Government, who are being urged to provide more and better support for working parents. Dr Helena Falkenberg from Stockholm University and a team of colleagues have been investigating and find that these other factors do indeed matter, especially for women in senior level jobs.

Being in a job we enjoy and having a family are sources of great satisfaction, but also of conflicting demands. From organising childcare and sharing the housework to getting that all important report done on time and preparing for a big presentation, being a working parent can be tough at times.

Maybe there’s a special breakfast meeting that means mum or dad can’t take the kids to school or perhaps one of the children is suddenly unwell and decisions need to be taken around which parent will take time off. Work gets in the way of family life and family matters can prevent us getting on with our work.

A recent report from the Chartered Institute of Professional Development (CIPD) called for a step change in support for working parents from UK Government and employers, claiming initiatives such as Shared Parental Leave and free childcare policies are not hitting the mark, despite being well intentioned.

In this research, rather than looking simply at how and to what extent men and women are conflicted over work and family, we try to pinpoint more clearly other aspects of our lives that might be linked with conflict. In that we way, we can identify more clearly the sorts of individuals at greatest risk which in turn might help employers and policymakers identify and target support at specific groups.

This study investigated the links between gender and socioeconomic status (specifically in this case the type of job people did) and levels of conflict. It also examined how levels of control at home and work increased or reduced conflict.

The findings suggest that if you are a woman or have a higher level job, you are most likely to experience conflict between work and family life. In addition, the less in control you feel at work and at home, the greater that conflict is for both men and women.

Our study highlights the need to make it easier for higher status employees to combine work and family, especially women, and to increase the levels of control at work and at home to help individuals manage work and family successfully.

Civil servant data

We used information from the Whitehall II study of nearly 3,500 British civil servants (2,657 men and 827 women) in the 1990s. They were grouped into three different socioeconomic status levels

  • Senior administrative
  • Executive/professional
  • Clerical/support

Participants in the study were asked whether and to what extent their work interfered with family life. For example did work commitments reduce the amount of time they could spend with the family. Did their job involve a lot of travel away from home and did it make them irritable at home or leave them lacking the energy needed to do home and family related things.

When it came to how family got in the way of work, they were asked if family matters distracted them from getting on with work, prevent them from getting enough sleep to be do their job well and having enough time to themselves.

To dig deeper into the question of how in control they felt at work and at home, they were asked a range of questions including much say they had in decisions at work, how much choice about what they did and how much flexibility there was. For control at home they were asked to what extent they agreed or disagreed with the statement: “At home, I feel I have control over what happens in most situations.”

When we took into account factors such as part-time work, whether the individuals were married, had children or other caring responsibilities, women reported more conflict between work and family than men. When we added in to the analysis how much control over work and home life participants felt they had, the difference between men and women was even more pronounced.

Having a more senior position was also a key factor for both sexes, but especially for women. The small number of women at high grades in the civil service and other areas of the labour market appears, to some extent, to reflect the difficulties for women in high positions to combine work and family. Notably in our study sample, more than half of the women with senior level jobs did not have children.

When it came to how family interfered with work, once again women fared worse than men, with women having more than twice the risk of their family life interfering with their work life. Of the women, those in higher positions fared worst of all. The type of job the men did in the study did not make a difference to the levels of interference.

Being in control

Participants who reported low levels of control at work were most likely to say that work interfered with family life, indicating that more control and flexibility at work eases the transition between work and family. There was less of a link between low levels of control at work and those reporting family interference with work. However the interaction between control at work and the influences of socioeconomic status and gender needs further research to draw significant conclusions.

Low levels of control at home also contributed to a markedly higher risk of work-family and family-work conflict. This seemed to be equally important for women and men no matter what their position at work. To develop effective policies on work-family balance, the home sphere will need further research.

One limitation of our study is that it was conducted among white-collar British civil servants, and the findings may differ among other working populations and, particularly, in different countries with different social security systems. Information was also collected some years ago.

However, we found clear evidence that women experienced more interference between work and family and vice versa than men, especially women in senior positions. This is important as it might influence their career choices and their health over time.

We hope this research and further work in this area will help employers and Government to get a more nuanced picture of what factors are at play when it comes to the issues facing working parents, and ultimately develop initiatives and approaches that can reduce the conflict in a way that helps them to thrive at work and at home.

Further information

Do gender and socioeconomic status matter when combining work and family: Could control at work and at home help? Results from the Whitehall II study is research by Helena Falkenberg and Petra Lindfors of Stockholm University, Tarani Chandola of the University of Manchester and the ESRC International Centre for Lifecourse Studies, and Jenny Head of University College London. It is published in the journal Economic and Industrial Democracy.

Want to be fit at forty? Don’t have a baby early!

Having a family early may not be good for your health later on. That was the conclusion of a team of researchers at the ESRC International centre for Lifecourse Studies when they looked at the interplay between the work and family lives of men and women, whose lives have been tracked over time in the 1958 Birth Cohort Study. But was it the same story for people born earlier and has it been the same for people who were born later? Dr Rebecca Lacey, who led the research, has been looking at the lives of thousands of adults in three Birth Cohort Studies to see whether the way their work and family lives intertwine impacts on the likelihood of them becoming overweight or obese later on.

In a recent blog for WorkLife, my colleague Anne McMunn outlined some of our research showing that, for both men and women, having children early, especially as a teenager, was closely linked with poorer health once they got into their forties.

Not only did the people we looked at for that piece of research have bigger waists, but they also had a great deal more fat circulating in their blood and less ‘good’ cholesterol, both of which are linked with a heightened risk of heart disease and diabetes.

Those findings stayed strong, even for young parents who had a job and were married, a clear indication that having children early on, with all the associated stresses and strains, seems to take a heavy toll on health over the life course.

For that piece of research, we looked only at people who had taken part in the National Child Development Study, also known as the 1958 Birth Cohort. For this research we looked, in addition at thousands more people, born in 1946 (National Survey of Health and Development) and another group born in 1970 (the British Cohort Study) whose lives had been tracked since birth.

Across cohorts

The reason for looking across cohorts was to see whether changes across generations in how we combine work and family (having children later, more cohabitation and less marriage, more women working etc.) have contributed in some way towards poorer health for some.

As with the earlier research, we made use of 12 specially created lifecourse types covering information on employment, partnerships and parenthood, such as ‘Work, Later family’ ‘Later family, Work break’, ‘Teen parent’.

Each individual in each birth cohort was ascribed a lifecourse type and this was then linked to their Body Mass Index (BMI) and how that changed over time. We went on to see how those figures differed between lifecourse types within and across the three cohorts. We used the World Health Organisation’s (WHO) definition of overweight (BMI greater than or equal to 25) and obesity (BMI greater than or equal to 30).

In addition, we took a host of other factors including our participants’ socio-economic background, prior health and educational attainment into consideration.

We anticipated that, as our earlier research had shown, that people who worked less and had children earlier would show steeper increases in BMI and that across the three cohorts, those increases would become more pronounced.

Changing attitudes and behaviours

The distribution of lifecourse types across the three cohorts reflected, as we thought it would, changing attitudes and behaviours across generations, with increasingly more women in employment and early parenthood becoming less and less common.

In the 1946 cohort, the average BMI of a very small group of men who were ‘Teen parents’ increased from 20.3 to 26.76 between age 16-42, significantly more than any other work-family combination. The same was true for male teen parents in the 1958 cohort and also for those who worked and had a family early. In the 1970 cohort, men who had no children or had children later had BMI that increased significantly less than those who became parents earlier. The only exception to this was a group of men with no family and unstable work.

Another notable finding across all three cohorts was that average BMIs for men at age 42 in all of the work-family groups were higher than the WHO threshold for overweight. The only exception was men who had children later or no children at all.

For women in the 1946 study, there was no real difference between the groups when we looked at how their BMI increased between the ages of 16 and 42. The average BMI of the 1958 cohort women who had children early increased significantly more than that of women who had them later. Women in the 1970 cohort who did not work and had children early had the biggest BMI rise (6.69) with teen parents (6.31) close behind. The average BMI of the 42 year-old women in these two groups was on the WHO obesity threshold (30), with the average BMI for the remaining work-family groups all falling under the WHO definition of overweight (25 and above).

Other interesting things to emerge included:

  • BMI increased more for male teen parents than female in the 1970 cohort
  • Marriage seems to have particular health benefits for men
  • Divorce has greater negative health effects for men than women

Negative impact

This research reinforces what we found earlier, which is that for both men and women having children early (especially in your teens) no matter what your background, is likely to have a negative impact on your health in mid life, especially if you don’t have a job or if your work is irregular or unstable. Looking across three cohorts, we can also see that those differences have become more pronounced.

How to explain and better understand how all this plays out in the day to day lives of younger parents is a challenge. Having children early may disrupt someone’s education or career. Younger parents may also be more likely to smoke and drink and exercise less than their older counterparts, unhealthy behaviours which can become established early and set in across adulthood.

Whatever the context and the reasons, there are some important messages here for young people, prospective parents, health and education professionals as well as for Government; not least that decisions about how to combine work and family life, especially when to become a parent, may have long lasting ramifications for your health.

This research adds to a growing body of evidence which makes it clear that, as far as obesity is concerned, early intervention is key and that we need to consider the complex way in which our biological and social lives intertwine over time.

Further information

Work-family life courses and BMI trajectories in three British birth cohorts is research by Rebecca Lacey, Amanda Sacker, Steven Bell, Meena Kumari, Diana Worts, Peggy McDonough, Diana Kuh, and Anne McMunn. It is published in the International Journal of Obesity.

Photo credit: Baby Fingers, Thomas

Never too early, never too late

N2EN2L_620x877The research team at the ESRC International Centre for Lifecourse Studies at UCL has produced a plain English booklet summarising some of its recent research and what can be learned from it in respect of living as long and as healthy and happy a life as possible.

Never too early, never too late shares a number of important research findings from research making use of longitudinal surveys such as the British Birth Cohort Studies and the UK Household Longitudinal Study.

The free booklet explains why it’s so important to take a life course approach  to research and the benefits off looking at how our social and material circumstances and our biology intertwine to impact on our health and happiness over time.

Issues covered include mental health, obesity, stress and its links to chronic illnesses such as cancer and heart and lung disease,  cancer, diabetes and dementia.

Further information

Reform and retirement: pension lessons from Finland

Pension reform is taking place in countries around the world. Governments, businesses and individuals have gradually come to terms with the fact that one of the consequences of us all living longer is that existing pension arrangements are unsustainable. As a result, millions of workers are being encouraged, nudged or, in some cases, forced to work longer. But what if reforms don’t work or have a different impact from that intended? Tarani Chandola from the ESRC International Centre for Lifecourse Studies and University of Manchester has been analysing the complex interplay between pension reform and our health and their combined effect on the timing of retirement.

We all need to work longer and retire later! Those are the essential messages coming from Governments around the globe. Turning those messages into concrete change that can make pension systems sustainable, however, is no straightforward matter, especially when you take into account the health problems that older workers can face.

The combined impact of pension age policies and our health on our decision to retire and the complex way those things play out are not very well understood. Many people stop workingbecause or ill health or caring responsibilities. Changes in the age when people can claim their state pension, which is increasing in the UK, could deter people from retiring when they perceive they need or want to.

Our research took a close look at pension reforms introduced in Finland in 2005, where, in place of a fixed statutory retirement age of 65, workers were given the choice of retiring between the ages of 63-68. The central goal of the reform was to ensure the sustainability of the pension system and to promote longer working lives. To try to get more people retiring at the top end of that age range, financial incentives were introduced for those who opted to retire later.

We looked at people who retired before and after the reforms to see whether the changes to the system had the desired effect of getting people to work longer. We also wanted to see if people who opted for early retirement (between the ages of 63-64) tended to be in better or poorer health.

Health issues linked to retirement

Our research made use of information from the medical and retirement records of more than 20,000 men and women born over a 9 year period. As far as their health was concerned, we focused on issues most closely linked with retirement such as circulatory disease and bone and muscular problems like arthritis as well as mental health problems. We were also able to access records of the sorts and quantities of prescription medicines that people were taking in the run up to retirement.

Looking at the pre-reform group, there was a clear decreasing trend in retirement by age 63 and by age 64. Among the post-reform group, there was no clear trend, but each birth cohort was substantially more likely to have retired by the age of 64 than those in the pre-reform cohorts. In fact, workers subject to the new system were 50% more likely to retire age 63-64 than those in the old.

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Although retirement was generally more common among people with poorer health, as we thought would be the case, it was striking that the increased numbers of people retiring early in the post reform group tended to have better health.

In short, the reform encouraged more people to retire earlier. Those in poor health were just as likely as before to retire early, but among people with better circulatory, muscular, bone and mental health, retirement at 63-64 increased substantially. Even when we took a range of other factors into account, such as their social and economic circumstances and their education, their good health was a strong predictor of retirement.

Unintended consequences

A more flexible retirement age, in Finland’s case, has had the unintended consequence of encouraging more, not less people into early retirement. Many of those were people in good health, the sorts of workers who might have several healthy working years ahead of them – the sorts of people the Finnish Government would have hoped would retire later.

Further reform is already on the cards for Finland in 2017 and is likely to see the lower age of statutory retirement raised to 65 and after that linked to life expectancy.

Here in the UK, we have seen the raising of the State Pension Age to 67 for men and 65 for women with further changes slated for the future. Only time will tell if it has the desired effect of keeping people who otherwise might have retired earlier in work or whether other factors, such as an individual’s health will play a stronger role in those decisions.

Our study shows that, regardless of what is happening with pension reform and policy, those in poorer health are unlikely to be able to extend their working lives no matter what, something Governments everywhere need to build into their thinking about pension reform.

Further information

Health as a predictor of early retirement before and after introduction of a flexible statutory pension age in Finland is research by Taina Leinonen, Mikko Laaksonen, Tarani Chandola and Pekka Martikainen

Photo credit: United Soybean Board

Who works post State Pension Age?

Across Europe and indeed other parts of the world, we’re being told we need to work longer than in the past. The reason? We’re all living longer and pension systems everywhere are collapsing under the strain. But with age can come poorer health and reduced physical capabilities and what if doing our job is physically or mentally demanding? Raising the State Pension Age for this group of workers compared say with someone working in a less stressful job could end up creating pressure on specific disadvantaged groups, whilst favouring already advantaged groups. Morten Wahrendorf from the University of Dusseldorf and ESRC International Centre for Lifecourse Studies has been investigating.

A number of Governments across Europe have already increased the state pension age beyond 65 and are actively looking to introduce incentives and measures that they hope will get more people of working age to retire later.

Quite a lot of research has looked at what things are going on in people’s lives that might lead them to retire early from work, but far fewer questions have been asked about what might lead to someone working beyond state pension age. What sorts of jobs do they tend to do? What are their working conditions like? How do those compare with people who retire earlier?

It’s important to get a grasp of this if we are to ensure that any changes made to the pension system are fair and just and that they don’t adversely affect specific or already disadvantaged groups.

Using information on nearly 18,000 men and women aged 65 and over from 16 European countries we were able to look into this in some depth and effectively compare prior working conditions of those people who retired early with current conditions of those who worked longer.

Work and conditions

Our information came from the Survey of Health, Ageing and Retirement in Europe (SHARE). We looked at whether the participants were employed or not, their job (at the time of the survey and immediately before retiring), how long they had been doing their job, working hours and how stressful their job was.

In addition we looked at what the participants said about how much freedom they had at work, whether there were opportunities to develop new skills, whether their job was physically demanding or time-pressured and how supported and recognised they felt at work.

As far as survey participants’ health was concerned, we were able to see how they rated their own health, whether they were depressed, their quality of life, and how mentally and physically capable they were.

Workers better-off and better-educated

Of everyone we looked at in the study, 755 (4.3 per cent) were still working between the ages of 65 and 80. They tended, on average, to be better off and better-educated than those who had retired.

Those still working were three times as likely to be self-employed as our retired group, who were also less likely to have been in a managerial or professional job before retiring.

Those who had retired reported higher levels of stress in their last job, particularly when it came to how valued and supported they felt. They also had poorer health across the board on all the measures we looked at.

Figure 1. Prevalence of poor health by labour market situation among older men and women (aged 65 to 80 years) in percentage (n=17625

ICLS-health

These findings were still seen even after accounting for a host of other factors including their sex, education, whether or not they were in a relationship, if they had children and how well off they were, and also country affiliation.

There is robust evidence here that across Europe people who are likely to work longer are those who are self-employed or in a good job where they are in control and feel well supported and valued. They are also in better physical and mental shape than their retired counterparts.

Raising the State Pension Age or offering tax incentives to people to work longer may well favour certain groups who are already doing better than their peers in a number of ways. It could also place increased pressure on people already in poor health and in poor quality jobs.

All this needs to be taken into account by Governments looking to plug the pensions gap and by employers who will need to provide good jobs in a better, less stressful working environment if their workers are to remain productive post 65.

Further information

Photo credit: Fish, nico_enders

Empower employees! They will retire later

Working longer has become a policy priority in recent years, but how can people be actively encouraged to retire later? What needs to change in the workplace in order to persuade people to extend their working life? UCL’s Ewan Carr, as part of the renEWL project, has been looking at survey information from the English Longitudinal Study of Ageing (ELSA) to see what matters to older workers when it comes to deciding whether or not to retire.

Rates of employment among older workers (aged 50-64) may have increased in the last decade or so, but across Europe, significant numbers of people in this age group continue to retire before the statutory pension age. In fact, more people retire before statutory pension age than after it.

For policymakers seeking to change that position, and for businesses looking for how best to modify the workplace to help achieve it, a better understanding of the drivers behind early retirement is essential.

Job demands and conditions

We looked at the working lives of nearly 3500 members of the ELSA study to see whether the demands and conditions of their job influenced the preferred and actual timing of their retirement. We focused on the mental as well as the physical demands of their job.

We anticipated that those with physically and mentally demanding jobs would prefer and, where possible, opt for early retirement, whilst those with fulfilling jobs, with decision making powers, support and recognition, good career opportunities and financial reward would be happy to work longer.

Participants in the study were asked how physically demanding their job was, how much time pressure they were under at work, how much control they had and to what extent they felt supported and recognised.

After taking a range of factors into account, the mental demands of a job, control at work and low recognition were the most influential when it came to retirement timing preferences.

Retirement preferences

We found that employees who reported having to ‘work very fast’ or being under time pressure preferred to retire 3 months earlier than those who said this was not the case. Employees who reported having low levels of control at work and low recognition wanted to retire around 5 months sooner than their peers.

The likelihood of actually stopping work (as opposed to wanting to stop work) was also influenced by levels of decision control, support and recognition. Employees with high levels of control were less likely to stop working, compared to those with low levels of control. Employees who felt poorly supported or that their work wasn’t recognised were also more likely to give up work.

It seems that even though a mentally demanding job might lead someone to say they would like to retire early, this doesn’t always lead to them leaving work. Other factors, besides the workplace environment, may prevent older workers from retiring when they want to.

Those who want to keep working might end up retiring early due to poor health or caring responsibilities. On the other hand, employees who want to retire early (due to the demands of work) might lack the necessary pension or financial savings to make this possible.

Our findings indicate that increasing job control from low to high could postpone retirement preferences by as much as two years – a clear indication that modifying the workplace could and should be a focus for policymakers and businesses aiming to extend working life.

Working conditions as predictors of retirement intentions and exit from paid employment: a 10-year follow-up of the English Longitudinal Study of Ageing is research by Ewan Carr, Gareth Hagger-Johnson, Jenny Head, Nicola Shelton, Mai Stafford, Stephen Stansfield and Paola Zaninotto. It is published in the European Journal of Ageing

Photo credit:  Hiroyuki Takeda

Out of work again? The psychological impacts of repeated unemployment

Being unemployed is bad for our mental well-being, but if we lose our job more than once does the psychological blow lessen in some way? Researchers Cara Booker from the University of Essex and Amanda Sacker at the International Centre for Lifecourse Studies at UCL used the long-running British Household Panel Survey to examine the psychological well-being of people who have repeatedly lost their jobs. Their findings show that our employment history makes a difference and could have implications for welfare to work initiatives from Governments looking to get people back to work.

Continuous employment may be what is best for us, but of course life is not always that straightforward and, at any given time, a significant proportion of the population will be out of work. This could be because we choose to take time out to undertake training or to have a family. We may fall ill or be made redundant.

The world of work is also becoming more flexible. Fewer people are staying with the same firm for long periods of time and more people are moving from contract to contract or job to job, sometimes with spells of unemployment in between.

At the same time, the Government wants to get more people off benefits and into work and is looking to make its Work Programme more effective.

Using 17 years of data collected from the participants in the British Household Panel Survey (1991-2008), we looked at any individual who had reported at least one spell of unemployment. Of these 1,642 participants, 82 per cent were unemployed once, 15 per cent twice and 3 per cent three or more times.

Mental health score

Participants were asked a range of questions about their mental health and answers to these were used to allot a score with 0-11 indicating good psychological health and 12 or more indicating stress or anxiety that could lead to ill health. The time periods before and after a spell of unemployment were also taken into account because job loss isn’t generally something that happens suddenly and there can be weeks or months building up to it.

Looking at the group as a whole, we found their psychological well-being was generally poorer during all spells of unemployment compared with when they were not unemployed, but there was no evidence of a lowering or increasing of the effect from one spell of unemployment to the next.

When we dug deeper into participants’ prior work history, however, we saw some differences between those people who had previously been ‘economically inactive’ (voluntarily not working e.g. to look after family or study) and those who had been working.

Those who prior to being employed had been ‘voluntarily’ not working suffered poorer psychological well-being after they went on to lose their job but became notably worse in the third spell of unemployment.

The previously employed group’s psychological well-being also took a knock after losing a job once and then again, but, by the third time there was no change, a possible indication that the individual is somehow adapting or getting used to dealing with the ‘shock’ of becoming unemployed.

When we compared levels of psychological well-being between these two groups, they were notably lower among the previously employed at unemployment spells one and two, but this was reversed at spell three.

Employment history matters

So only when we took into consideration being economically inactive as opposed to employed, did a slightly clearer picture emerge around this question of whether people adapt to the ‘shock’ of unemployment, with those previously employed seeming to adapt and those previously economically inactive becoming increasingly sensitive to it. These findings were given further weight when we looked at retrospective employment histories before the BHPS began.

One explanation for this is that those who come from an employed background tend to find work again after each unemployment spell they experience, so they become less anxious about finding another job. The economically inactive, meanwhile, seem to find it harder to enter and re-enter the job market which could account for increased anxiety with more attempts to sign up as ‘unemployed and seeking work’.

Household income also played a role with those who were economically inactive on higher than average incomes experiencing worse psychological well-being than their less off counterparts when making an unsuccessful attempt to enter employment.

In its recent Welfare-to-Work report, the Work and Pensions Committee pointed out that key to the programme’s success was providing unemployed people with “the right help at the right time” and a better understanding of the barriers and characteristics that prevent a swift return to work. A better understanding of the impacts of repeated spells of unemployment on people’s well-being would seem to resonate here.

It is also clear that good quality, secure employment opportunities with long term prospects are key to people’s health and happiness.

Psychological well-being and reactions to multiple unemployment events: adaptation or sensitisation? is research by Cara Booker and Amanda Sacker and is publishes in the Journal of Epidemiology and Community Health

Photo credit: Kathryn Decker

 

Having a baby early? It might not be good for you later

Being employed is generally good for your health. That’s what a large body of research has shown over the years. But what about when you put having a family into the mix? That’s a question that Dr Anne McMunn at the ESRC International Centre for Lifecourse Studies at UCL has been asking in a series of studies looking at the interplay between work-family life and health in middle age. Here she outlines her findings and explains why having children early may not be good for you.

When couples think about starting a family, they may make decisions around a host of concerns. Finances, careers, childcare all spring readily to mind as things that could crop up in discussions about when it might be best to have a child. Not many people will stop and think about how and when having a child might affect their health later on in life – but maybe they should.

Research to date has shown that combining paid work with family responsibilities is usually linked with better health outcomes, although existing research has a number of shortcomings: men are often excluded, health measures have tended to be self-reported rather than objective, few studies take account of the role health plays in whether or not people work, get married and have children in the first place, and, crucially, few studies look across the lifecourse at the timings of entry into parenthood.

Combining work and family life

Using the National Child Development Study, which is following the lives of 17 thousand people born in 1958, our research has looked at how they combined their work and family lives between the ages of 16 and 42 and what that meant for their health in their mid 40s.

The thinking behind the research was that those people with more stressful work-family lives (often characterised by having children very young, being unemployed, and not marrying or forming a long-term partnership) would go on to have physical signs or indicators of poor health such as high cholesterol and blood pressure, being overweight etc.

All the men and women in the study were ascribed one of 12 lifecourse types e.g. ‘Work, Later family’, ‘Later family, Work break’, ‘Teen parent’.

Table 1-1

Almost all men were in a group characterised by long-term full-time employment, with most (34%) entering family life later (the ‘Work, Later family’ group), with nearly as many entering family life earlier (the ‘Work, Earlier family’ group at 32%). Conversely fewer than half of women (47%) were in a group characterised by long-term full-time employment. The ‘Part-time work, Earlier Family’ was the most common group (18%) for women.

Similar proportions of men and women were in the ‘Work, Cohabitation, Later Parent’ group (7% and 5%, respectively), the ‘Work, Marriage, Non-Parent’ group (8% of men, 9% of women) and the ‘Work, No Family’ group (13% of men, 10% of women). Only 4% of women were in the ‘No Paid Work, Earlier Family’ group, and few men or women were in groups characterised by marital dissolution, teen parenthood or weak ties to work or family.

Early parenthood – poorer health

As we expected, those men and women who were in full-time long-term employment, were married and had children later on enjoyed better health. Early parenthood, especially teen parenthood was clearly linked to poorer health, regardless of whether they were in paid work or in a stable long-term marriage.

For example, the waist circumference of teen parents was four inches larger, on average, than those who were in full-time long-term employment, were married and had children later (fat accumulated around the waistline is known to be particularly risky for health). Groups who entered parenthood earlier had 10-18% more fat circulating in the blood and 2-8% less of the ‘good’ HDL cholesterol than those who were in full-time long-term employment, were married and had children later.

Teen parents tended to be less well educated, which accounted for some of the link. However, even those who had stable employment and marriages, but had children early, had poorer health.

It seems that for both men and women, having children early is linked with poor health later on, possibly as a result of chronic stress from parenting in straitened circumstances with fewer financial and emotional resources.

Less human and social capital

Authors of other studies showing links between early parenthood and health problems such as depression, heart disease and long term illnesses, speculate that younger parents have accumulated less human and social capital to cope with the stresses of parenting. It is also possible that those who are older when they become parents have had time to establish healthier behaviours such as exercise and healthy eating prior to starting their families, making it easier to maintain those behaviours through the busy parenting years.

There is need for further evidence on how timing of parenthood influences health and we are currently replicating this study with participants from the 1970 birth cohort.

In the meantime, perhaps those family planning discussions around finances, careers and childcare should incorporate an extra question? If we have a child now rather than later, how might it affect our health later on? It’s a question that will be of interest not just to prospective parents, but to all those concerned with improving the long term health and well-being of our society.

Work-family life courses and metabolic markers in mid-life: evidence from the British National Child Development Study is research by Anne McMunn, Rebecca E Lacey, Meena Kumari, Diana Worts, Peggy McDonough and Amanda Sacker.

Photo credit: Darren Johnson

 

Are permanently sick people less sick nowadays?

Brexit aside, there have few topics more hotly contested in recently years than who should get incapacity benefits. The steady rise in the incapacity benefits bill over several decades led some to question whether greater numbers of people could actually be sick and whether this group is actually healthier, with less serious health problems, than had been the case in decades past. But what does research evidence tell us? Bola Akinwale from Public Health England and colleagues at the ESRC International Centre for Lifecourse Studies have looked at 30 years’ worth of data to see.

In the last 30 years of the 20th century, life expectancy for those aged 65 increased more than it had in the previous 70 years. A job market that had been almost completely dominated by men became dramatically more diverse. By the turn of the century, very few men aged 60-64 were in paid work, although that number has since increased.

On the face of it, many of these changes represent good news, but they have also created new challenges around funding pensions and how to keep increasing numbers of older people healthy and active for longer.

Our research looked at the proportions of men and women around State Pension Age who were employed, unemployed, permanently sick (those we might expect to claim incapacity benefits) or retired. We went on to look at their health immediately after retirement age to see if they had died prematurely or had a limiting long-term illness or disability.

When we compared the labour market positions of 60-64 year-old men in 1971 compared with 2001, we saw some big changes:

  • Working – 78.4 percent v 47.5 percent
  • Retired – 7.2 percent v 24.7 percent
  • Permanently sick – 9 percent v 19.7 percent

By 2001, women were almost as likely as men to describe themselves as retired after State Pension Age and 12.4 percent of 55-59 year-old women described themselves as permanently sick in 2001 compared with 3.4 percent back in 1971.

So we see the proportions of permanently sick men doubling over 30 years and quadrupling for women.

Across the same time frame, the risk of dying just before State Pension Age decreased substantially – by more than 60 percent for men and by more than 50 percent for women, irrespective of whether they are in work or permanently sick. In other words, both groups benefited equally from these changes – staying healthier and living longer than their counterparts 30 years previously.

Are sick people less sick nowadays?

 The answer is no and yes – it depends on the comparator.

To try to get to the bottom of this idea that people who are permanently sick are less sick than their historical predecessors, we compared the likelihood of them dying prematurely with that of their working peers.

On the one hand, if they were less sick, we would expect to see the gap between the chances of dying prematurely for these two groups get smaller over the 30-year period. We don’t see that.

Permanently sick men aged 65-69 were three times more likely to die prematurely than their working peers in 2001 and this was an increase on the 1971 figure. For women, the figure was between four and five times over the period we looked at.

On the other hand, it’s clear that this 30 year period brought about some remarkable changes in the working lives and general health of older people, including among permanently sick group. Their life expectancy has increased in line with other people of their age.

But despite these improvements in life expectancy among permanently sick people, compared with employed people their likelihood of dying has, if anything, slightly increased and certainly not decreased.

So, taken together, our research does not support the argument that the permanently sick have less serious health conditions nowadays than they used to.

A key plank of the Government’s policies for people who are unable to work due to illness is to try to support them back to work wherever possible. Our research shows that achieving this aim, requires careful consideration of the types of jobs and working environments that might be suitable for people with chronic illnesses.

If we don’t create enough jobs that older people with chronic illness can sustain and thrive in, life expectancy gaps between those in work and those who leave the workforce prematurely due to ill-health may widen further.

Work, permanent sickness and mortality risk: a prospective cohort study of England and Wales, 1971-2006 is research by Bola Akinwale, Kevin Lynch, Richard Wiggins, Seeromanie Harding, Mel Bartley and David Blane. It made use of linked census and death records in the ONS Longitudinal Study.

Photo credit: ILO in Asia and the Pacific