Tag Archives: Career

Are universal state pensions discriminating against those in lower-skilled jobs?

With the state pension age likely to rise further in coming years, are policymakers right to link pension eligibility to average life expectancy? In a one-size-fits-all system, which social groups will lose out? Dr Emily Murray and colleagues* used census data to look at who lives longest after leaving work.

In most industrialised countries, the eligibility age for state pensions is being increased. Between 2011 and 2018, the United Kingdom government raised the State Pension Age for women from age 60 to 65, to match that for men, and a further increase to age 67 for both genders is planned by 2028. A further increase to age 68 by 2039 has been mooted.

Yet our state pension system ignores some very basic facts – it doesn’t take into account the wide disparities in health and life expectancy between different social classes. Those in professional occupations can expect to live longer and to enjoy good health for longer than those in manual jobs. For example, the average 50 year-old man in a professional job can expect to enjoy a further 25 years of good health, while a man the same age in a manual occupation can only expect 18: a seven-year difference. That is why lower social class groups are more likely to find themselves on disability benefit.

We wanted to look more closely at these occupational social class differences in the amount of time older adults live after they stop work, and in particular at the extent to which these differences are due to health.

We used the Office for National Statistics Longitudinal Study, a one per cent representative sample of respondents to the English and Welsh censuses since 1971.  For our analysis, we included respondents who were aged 50-75 at the time of the 2001 census and who had stopped work by 2011 – the average age of stopping was 58 for women and 60.2 for men. These workers were born in 1951 or earlier, so men would have been eligible for state pension at 65 and women at 60.

That gave us a sample of 76,485 people, and over the next 10 years we were able to monitor deaths  – by 2011 14.6 per cent of the women and 25.1 per cent of the men had died.

We could see that for both genders, those in lower social classes tended to die younger – professional women lived two years longer than unskilled women, and professional men three years longer than unskilled men.

We estimated professional women in good health would live five years longer than unskilled women in poor health, while for men the gap would be five and a half years.

But despite these longevity gaps, those from lower social groups were facing more years between leaving work and being able to draw their state pensions – because they left work earlier.

We estimated that if two women were 65 in 2001, the woman who had worked in an unskilled occupation would live five years longer after leaving work than the professional woman with good health – because the unskilled woman would have left at a younger age. Two men in the same circumstances would live on average 25.0 and 19.5 years from stopping work to death.

The most likely explanation is that poor health has a greater impact on the ability of manual workers to continue working than it does on non-manual workers.  It is however important to note that associations between social class and post-work years were not entirely explained by health, and we feel more research is needed on this.

Poor health

But the conclusion is clear: our results show that a uniform state pension age disproportionately affects the poorest among us, because on average they must wait longer between stopping work and qualifying for their state pension, at a time when they are likely to be in poor health. This is despite the fact that they are likely to have started work younger and therefore to have worked and paid contributions for just as many years as their better-off peers.

The solution to this inequality is not straightforward. The preferred strategy for UK policymakers is to support individuals to stay in work for longer, and there is evidence that the average age of leaving work exit is increasing.  However, over half of women and two-fifths of men  still fall out of the labour market before state pension age.

Some researchers have suggested that pension ages should directly reflect life expectancy differences.  Alternatively the age requirement could be dropped and pension eligibility could be based solely on the number of years in work.

We believe a two-year earlier pension age may be more appropriate for individuals who work in manual occupations, given that they leave work earlier than professional workers not in good health.  With rises in pension age already in law, and evidence of stalling life expectancy, it is vital that researchers and policy-makers assess how these rises will influence financial security and health for the most vulnerable in society.

Inequalities in time from stopping paid work to death: findings from the ONS Longitudinal Study, 2001 to 2011 is by Emily T Murray,  Ewan Carr, Paola Zaninotto, Jenny Head, Baowen Xue, Stephen Stansfeld, Brian Beach and  Nicola Shelton.

*Emily T Murray, Ewan Carr, Paola Zaninotto, Jenny Head, Nicola Shelton and Baowen Xue are based at the Department of Epidemiology and Public Health, University College London.

Ewan Carr is also based at the department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London.

Stephen Stansfeld is based at Queen Mary University of London, Wolfson Institute of Preventive Medicine, Centre for Psychiatry, London, EC1M 6BQ, UK

Brian Beach is based at the International Longevity Centre – UK, SW1P 3QB, London, UK.

Job prospects: does it matter where we live when we are young?

What are the influences on our employment prospects across our working lives? Could where we live when we’re young be important when we’re older – regardless of our social class or level of education? A new study by Emily Murray and colleagues from UCL, King’s College, London and Queen Mary, University of London, finds if we live in an area of high unemployment when we’re young, we’re more likely to leave the labour market at a younger age.

Which factors can help improve our prospects of employment – and of good health – in mid-life? One reason the question is important is that if we can stay healthy longer and work longer, we are less dependent on the state. And the cost of our ageing society is a major issue for governments and individuals across the developed world.

In the UK the state pension age will be raised to age 67 by 2028, but in fact most employees leave work well before they reach that stage. For some that’s a positive thing, but for others it’s forced upon them by unemployment or poor health – and that contributes to social inequality among older people.

Who is at risk? We know older workers in areas of high unemployment are more likely to be on disability benefits. And older people are more likely to leave work for non-health reasons, too – if they are made redundant, they find it harder than their younger colleagues to find another job.

But until now we didn’t know much about how unemployment and other factors experienced by the young might affect their prospects of being in work as they approach the state retirement age.

‘Scarring effect’

There are good reasons to suspect there might be an effect –research has shown that periods of unemployment in young adulthood can have a ‘scarring’ effect – so it stands to reason that early work experiences could set some people on good trajectories and others on less positive ones.

Higher-level job opportunities aren’t evenly distributed, and so we might speculate, for example, that workers in the north – where access to careers in finance, for instance, would be poorer than in the south – would be less likely to start out on one of those ‘good’ pathways.

And education might make a difference, too. We know those growing up in poorer areas are likely to end up with fewer qualifications, and therefore to be disadvantaged in the jobs market. That, too, could continue to affect them throughout their lives.

So health, employment status, occupational class and education might all influence the length of our working lives and lead to unequal retirement outcomes.

Survey of health and development

We used the Medical Research Council National Survey of Health and Development (NSHD), a sample of all births in one week in March 1946 across England, Scotland, and Wales, to test our theories.

This group of people have been questioned 24 times throughout their lives, most recently in 2014 when they were aged 68. We used data from when they were aged four, 26, 53, 60-64 and 68 – a total sample of 2526 people, all of whom had given information on their retirement age or were still in work at age 68 years.

We found there was a correlation between increased unemployment rates in the area a person lived in mid-life and the likelihood of an individual retiring earlier.  However, this relationship was explained by where people lived earlier in life.

For example, cohort members who lived in an area with higher unemployment when they were 26 were more likely to be outside the labour market at age 53. Compared to those who worked full-time, those who were unemployed at aged 53 retired on average 4.7 years earlier.

Similarly, mid-life health problems were more common among those who had lived in areas with high unemployment at age 26, even when taking account of age 26 health status.

We did not find a direct link between educational achievement by age 26 and retirement age. We did, however, find indirect links: for example, those who did not obtain any educational qualifications by age 26 were more likely to live in areas of high unemployment than those who gained degrees. There was no association between area unemployment at age 4 and educational achievement at age 26.

Adulthood is key

Our findings show for the first time that early adulthood is a key life stage at which local labour market conditions can affect our eventual retirement age. We found this happened through two interlinked factors – high area unemployment and worse health status at age 26.

So, there are clear messages for governments: strategies to extend the working lives of future generations will be most effective if they address youth unemployment rather than focusing on older workers in areas with high unemployment.

Policies to extend working life should focus not just on individuals but also on the wider labour market context in which those individuals reside. Maintaining employment and good health in mid-life are key to ensuring that individuals can work longer. And large-scale interventions that create new jobs in areas with high youth unemployment could bring long-term positive consequences for future generations’ extended working lives.

Linking local labour market conditions across the life course to retirement age: Pathways of health, employment status, occupational class and educational achievement, using 60 years of the 1946 British Birth Cohort, is published in Social Science & Medicine.

Emily T. Murray,  Paola Zaninotto, Maria Fleischmann, Nicola Shelton  and Jenny Head are based at the University College London Department of Epidemiology and Public Health.

Mai Stafford and Diana Kuh were based at the Medical Research Council Unit for Lifelong Health and Ageing at University College London when this paper was written. 

Ewan Carr is also based at the Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London

Stephen Stansfield is based at the Queen Mary University of London, Wolfson Institute of Preventive Medicine, Centre for Psychiatry.

Retirement: good or bad for your heart?

Across the globe, more people are spending more time in retirement than ever before. So staying healthy in later life is critical. Yet political debates on ageing tend to ignore a growing body of research on how retirement can affect our health. Baowen Xue and colleagues from the Department of Epidemiology and Public Health at UCL looked at links between retirement and cardio-vascular disease – and found unexplained differences between Europe and the US.

Is retirement good for your heart, or bad for it? The question is an important one because cardio-vascular disease (CVD) is the biggest cause of death globally and costs health services a huge amount of money.

Some studies have shown retired people have a higher risk of being diagnosed with CVD than those who are still working. But until now the evidence has been unclear.

We set out to review evidence from across the world, so that we could help to build a more accurate picture of whether, and how, retirement might affect our cardio-vascular health. As CVD is linked to our lifestyle, diet and other behaviour, there are lots of ways in which changes that take place in retirement might have an effect – both negative or positive.

Longitudinal studies

We looked for longitudinal studies that could help answer our questions, and found 82 which measured risk factors for CVD and 14 which looked at actual incidence of CVD. The second set of 14 papers provided the answer to our first question – does retirement affect our cardio-vascular health?

The answer revealed a major difference between the USA and Europe. Studies conducted in the US showed no significant effect, good or bad, on retirees’ cardio-vascular health. In Europe, meanwhile – with the exception of France – studies consistently showed a link between retirement and an increase in CVD.

Data from the British Regional Heart Study, for instance, showed that healthy men who retired before the age of 60 were more likely than others to die from circulatory disease within five and a half years. Fatal and non-fatal CVD was also more common among retirees in Denmark, Greece, Italy and the Netherlands.

Why might this be? Could there be cultural or lifestyle differences between Europe and the US which might cause this difference? We took a systematic look at the risk factors.

Weight gain

First, we looked at weight gain. If Americans were less likely to put on weight after retirement compared to Europeans, that might help to explain the difference. But when we looked at this, we found that body mass index (BMI) actually increased after retirement in the USA – and also Japan -but did not change in England, Denmark, France, Germany, Switzerland or Korea. While those who do physically demanding jobs are likely to put on weight after they retire, most people aren’t.

Could it be that retired people generally do less exercise – another risk factor – in Europe? The studies suggest that’s not the reason. While many retirees did more physical activities, they also spent more time sitting still – so the effect was a balanced one. For instance, a retiree might play more golf, but also watch more television.

Do retired people perhaps smoke more, we asked? Again, there were contradictory results but 12 out of 14 studies either showed no effect or showed retirement led to people smoking less.

Perhaps retired people in Europe drink more, then? Again, this couldn’t be identified as the reason. Studies in Australia, the UK, Japan and the USA suggested there was no association between retirement and alcohol consumption.

Diet is another possible cause of CVD, but again, there was no clear pattern of between retirement and diet emerged from reviewed studies.

No benefits

So the picture isn’t straightforward, and we don’t have answers as to why retirement might put Europeans at risk but not Americans. What we can say, though, is that none of the studies we looked at found any beneficial effects of retirement on CVD.

Apart from a decrease in smoking, there wasn’t evidence of any general ‘relief’ effect of retirement on people’s cardio-vascular health – so the supposition that working could be bad for our health and therefore retirement better for it doesn’t necessarily hold true.

However, studies that showed retirement brought negative health effects should be interpreted with caution. Many assessed the health effects of retirement by comparing retired people with employed people – and we know people who stay in the labour market are generally healthier than retirees. We do know people who have CVD, diabetes or hypertension are more likely to retire.

What our review has done is to reveal the complex nature of the underlying mechanism through which retirement might impact on the risk factors for CVD. Different people react differently to retirement, depending on their life experiences and the cultural and policy environments in which they live. So there isn’t one global solution to any of this – each country needs to plan its citizens’ retirement according to their individual needs.

The impact of retirement on cardiovascular disease and its risk factors: A systematic review of longitudinal studies, by Baowen Xue, Jenny Head and Anne McMunn, is published by The Gerontologist.

Is working flexibly good for your health?

Flexible working is considered good practice – and in England, most workers have the right to apply to work flexibly after they’ve been in their job six months. But what do we know about the benefits? A new study by Tarani Chandola and colleagues used biological measures to look at differences in stress markers among workers with reduced hours and those without.

In recent years many employees have been able to alter their work patterns to fit in with childcare and other responsibilities. Typically, this can mean working part-time, job-sharing, only working during school term-times or working from home some of the time.

It’s assumed this should help to relieve stress. But until now, we didn’t know whether this was necessarily the case. After all, there could be down-sides – for example working at home can mean a blurring of the boundaries between work and family time, part-time working can be a barrier to promotion and job-sharing can bring its own tensions.

Until recently we had to rely on workers’ own reports of how they felt in order to judge this interplay between work, family life and stress. But now a number of social surveys have begun collecting samples which allow us to measure biological changes which can indicate stress, too.

This is known as ‘allostatic load’ – when we’re repeatedly subjected to stress or trauma, this can lead to chronically heightened levels of stress hormones. And that is associated with all sorts of long-term health problems, such as heart disease, type-2 diabetes and depression.

We were able to use data from participants in the Understanding Society study, which began in 2009 and which follows more than 60,000 adults in 40,000 households. As well as responding to detailed questionnaires, many of them have been visited by nurses who have taken physical measurements and blood samples.

Blood-based markers

As well as blood-based markers such as insulin growth factor 1 and cholesterol, their pulse rate, blood pressure and waist-to height ratio were also measured.

After taking out those who weren’t employed, who didn’t have the nurse visits or for whom some measurements were missing, we had a sample of a little over 6,000 people.

All those people had been asked whether flexible working arrangements were available at their workplace, how many hours they worked and whether they were the primary carer for their children.

We categorised working hours into three groups, with different levels for men and women because they tend to have very different working patterns. So women were grouped into those working less than 24 hours per week, more than 25 hours and more than 37 hours; while men were grouped into those working less than 37 hours, 37-40 hours and more than 40 hours.

Unsurprisingly, we found more women than men had made use of flexible working  arrangements – almost no men in our sample were the main carers for two or more children.

Chronic stress

There were particularly high levels of biological chronic stress markers among women with childcare responsibilities who worked more than 37 hours per week. Those with similar childcare responsibilities but working fewer than 25 hours per week didn’t have any measurable effect on their stress levels.

Both men and women who had access to, and made use of, reduced-hours flexible working had lower levels of biological stress markers than those who didn’t have flexible working.

We found these types of reduced-hours arrangement were more common among those in lower-paid occupations, especially among men, and among older workers of both genders.

Other types of flexible working arrangements, such as working from home, were more common among those from more advantaged social groups. But we didn’t find any association between these types of working and lowered levels of stress.

So, what has our study told us? We’ve learned a good deal about the complex relationships between social and biological factors in our lives. And, crucially for policymakers, we can see that it’s particularly important for women with childcare responsibilities to be able to access shorter working hours when they need to. For employers, this isn’t just a matter of logistics and of ensuring a stable and happy workforce – it’s also a major factor in ensuring that workers live longer and healthier lives.

Are Flexible Work Arrangements Associated with Lower Levels of Chronic Stress-Related Biomarkers? A Study of 6025 Employees in the UK Household Longitudinal Study, is research by Tarani Chandola (University of Manchester and UCL), Cara Booker, Meena Kumari and Michaela Benzeval (University of Essex) and is published in Sociology.

Would reducing social inequality lead to more years of healthy life?

Across Europe, there’s good news for older people – life expectancy is on the rise and levels of disability among older people are falling. But there are concerns that a longer life may not be a better life for all. So who benefits from increased life expectancy?  Jenny Head and colleagues from the IDEAR network find those with a higher occupational status can expect the greatest number of years of healthy, disease-free life.

We know from lots of studies that there are big differences in life expectancy between different social groups. And we know that those in higher social positions tend to benefit more from that rise in healthy life expectancy.

But, given that many governments expect people to extend their working lives, we specifically need to know about the different expectations of people in different occupational positions – which is slightly different.

Together with colleagues in the IDEAR networK, we looked at what those from different occupational backgrounds might expect in later life – to be precise, how many years with good health can they expect to enjoy between the ages of 50 and 75?

The data came from four cohort studies in England, Finland, France and Sweden.

We were able to look at data from 9,213 people in the English Longitudinal Study of Ageing from 2002 onwards. We also had information on 42,978 people who took part in the Finnish Public Sector study between 1997 and 2013. In France, we used the GAZEL Cohort Study, which gathered information from 18,263 people working for the national utility company from 1989 onwards. And in Sweden, we looked at a sample of 8,186 people who responded to the Swedish Longitudinal Occupational Survey of Health between 2003 and 2014.

Health measures

We used two health measures: whether participants rated their own health as good or poor, and whether they had ever been diagnosed with heart disease, stroke, chronic lung disease, cancer or diabetes.

In all the cohorts, people in lower occupational positions could expect fewer years of life than those in higher occupational positions – and they could expect to spend fewer of those remaining years in good health.

So in England, both men and women in high-grade occupations could expect more than four years’ extra healthy life when compared with men and women in lower-grade occupations. In Finland that gap was wider, with those in high-grade jobs expecting at least six and a half years more good health. In France the difference was around two and a half years, while Sweden had the smallest gap of a little more than two years.

This pattern was consistent across the four countries and for both men and women. There were also socioeconomic inequalities in chronic disease-free life expectancy, although these differences were less marked than for self-rated health.

Better understanding

Why does this matter? A better understanding of the future health of older people is crucial to policy-makers because it affects public expenditure on income, health and long-term care. It also matters because governments want to extend working lives and increase State Pension ages, and in order to do that they need older workers to stay healthy.

Our results indicate that those in lower socioeconomic positions may be doubly disadvantaged because they have worse health but may also need to work longer for financial reasons. To achieve extended working lives for all, policy-makers will need to find ways of reducing those social class differences in health expectancies.

Socioeconomic differences in healthy and disease-free life expectancy between ages 50 and 75: a multi-cohort study, by  Jenny Head, Holendro Singh Chungkham , Martin Hyde, Paola Zaninotto, Kristina Alexanderson, Sari Stenholm, Paula Salo, Mika Kivimäki, Marcel Goldberg, Marie Zins, Jussi Vahtera and Hugo Westerlund, is published in the European Journal of Public Health.

 

Early retirement – can welfare systems help ease the transition?

The post-war baby boomgeneration in developed countries is reaching retirement age and this is placing strain on welfare systems. Sol Richardson and colleagues from the ESRC International Centre for Lifecourse Studies at UCL find the type of welfare system under which we live can affect our prospects of having a happy and fulfilled retirement.

We know stopping work can lead to changes in our sense of personal wellbeing both positive and negative. And we know this can be influenced by a range of factors, such as whether an individual has left work at the usual age or has stopped early.

There are other factors which can make a difference to how we fare after retirement, too: If we were dismissed, retired through illness or through unemployment, for instance, the change is more likely to hit us hard.  

But how much difference do the different types of welfare system which exist in different countries make to those who leave work early? Until now we havent had much clear evidence on this point.

Data

We looked at a sample of people from 16 countries, using data from the Study of Health, Ageing and Retirement in Europe (SHARE) between 2004 and 2013, and from the English Longitudinal Study of Ageing (ELSA) between 2002 and 2013 these are studies which revisit their participants over time.

Our subjects were aged 50 years and over and had been visited before and after they left work.

We looked at a total sample of 8037 respondents who had left work between 2002 and 2013 and for whom we had information not only on work history but also on personal wellbeing.

We categorised how people left work according to the type of benefit they received afterwards: Were they receiving disability benefit, unemployment benefit, sickness benefit, social assistance, early retirement pension, old age pension or none of those?

Retirement age is different in different countries it can depend on gender or on the number of years worked, and its been rising in many countries. So we defined retirement as the earliest age at which an individual can draw a full pension if he or she has been working since the age of 20.

And we looked at the wellbeing of our subjects, using a validated scale called CASP-12 (control, autonomy, self-realization and pleasure.)

And then we compared these findings according to the type of welfare regime the participants had in their home countries again using an internationally-recognised scheme that relates to how social benefits are granted and organized.

Negative effects

We found that those who left the labour market because of unemployment or disability and who left outside of the typical time-frame tended to experience negative effects on their personal wellbeing.

How much difference did country of residence make? We found this was significant, but that only a small proportion of the difference was down to the country itself. Almost two thirds of the wellbeing gaps we found between individuals in different countries could be accounted for, we found, by the type of welfare system they had.

Those living in Scandinavian social democratic welfare systems experienced the most positive transitions but this effect is unlikely to be down to expenditure alone. Other factors could be important for instance, employment rules guiding the ways people left work. Different finance mechanisms, the extent of benefit coverage and the eligibility regime for those benefits could also have an effect.  

When we looked at the different types of welfare system we found people in systems which could be described as Bismarckian,such as France or Germany, or  Scandinavian,such as Sweden or Denmark, did better than those in systems which could be categorised as Mediterranean,such as Italy or Greece.

As a generalisation, Scandinavian systems can be described as Social Democratic. They spend the most, they have high levels of cash benefits and a strong emphasis on services.

Bismarckian countries emphasise earnings-related cash benefits like pensions and they provide reasonable services, but not at the level of Social Democratic countries.

In Mediterranean countries, the pensions system is fragmented and services are rudimentary. People living in Mediterranean systems are more likely to rely on family and the voluntary sector for support.

Policy implications

What lessons should policy-makers draw from our study? We found that higher expenditure per head, particularly expenditure on non-healthcare services such as home help, did help our participants to feel better after they left paid work.

And our results have important implications for welfare policy: They underscore the importance of welfare services as greater numbers of workers approach retirement age and leave the labour market.

Country-level welfare-state measures and change in wellbeing following work exit in early old age: evidence from 16 European countries, by Sol Richardson, Ewan Carr, Gopalakrishnan Netuveli and Amanda Sacker, is published in the International Journal of Epidemiology, 2018, 113.

Work stress and ill health – what’s the link?

Lots of studies have suggested stress can be a cause of ill health – and that leads to people ceasing to work before they reach retirement age. But most have offered only a snapshot on the issue. Now a new analysis of data from a major panel study by José Ignacio CuitúnCoronado and Tarani Chandola from the University of Manchester has shed new light on how work stress can affect an employee’s health over a longer period.

Many animals have the ability to adapt to environmental changes and pressures so that they’re better prepared the next time they happen. Bears can put on fat as winter approaches, for instance, to help them stave off hunger and stay warm.

And human beings can do this too. Stressful situations trigger chemical responses which can help to give us extra resources when things are tough. Our neuroendocrine systems, for instance, trigger hormonal responses which enhance our physical performance when we need it most.

But these valuable systems can have a downside. In our research, we wanted to look at how repeated exposure to stressful situations might contribute to health problems, particularly in people nearing the end of their working lives. We call this stress-induced effect ‘Allostatic Load’ – the wear and tear” on the body that accumulates as an individual is exposed to repeated or chronic stress because of fluctuating hormonal responses.

Given that many governments are looking for ways to extend working lives, there’s particular interest in finding out how stress can affect the health of older workers.We were able to tap into a rich source of information – the English Longitudinal Study of Ageing (ELSA), which has followed a representative sample of almost 10,000 over50s since 2002.

These participants have been interviewed regularly and one of the things they’ve been asked to report is whether they’ve experienced a sense of imbalance between the effort they put into their jobs and the rewards they get out.

Health testing

This gave us a sample of 2663 older adults, all over 50 and living in England, who’d reported these feelings at least once and who’d been assessed as having had an adverse reaction to them. We wanted to know whether repeated episodes had a bigger effect than just one, and whether the effect would be just as strong for past episodes as it was for more recent ones.

Between 2004-5 and 2014-16 the group were asked about stress at work, but they also underwent physical tests to see how the various systems in their bodies were bearing up.

They were visited by nurses who carried out a battery of tests including taking hair samples to assess levels of the stress-related hormone cortisol, carrying out blood pressure checks to provide information on their cardio-vascular systems, white blood cell counts to assess their immune systems and cholesterol checks on their metabolic systems. Participants also had measurements taken of their waist to height ratios – a good indicator of coronary heart disease risk factors.

Overall, we found the more occasions of work-stress a participant had reported, the greater their ‘Allostatic Load’ index – that is, the greater the amount of biological wear and tear. Moreover, the evidence suggests that employees who had experienced stress more recently (towards the end of their working career)had higher levels of health risk when compared to those who had experienced it earlier in their careers.

This suggests there is an association between repeated reports of stress at work and biological stress mechanisms, which in turn could lead to stress-related disorders such as coronary heart disease, type-2 diabetes or depression. This also suggests that previous cross-sectional studies which reported small or inconsistent associations may have suffered because they were only measuring one effect at one time.

Work-related stress is one of the reasons for labour market exit – and our findings would suggest that earlier, snapshot studies may have underestimated the true effect of work-related stress on health over a lifetime.

As this is an observational study, it is not possible tomake any causal claims. Also, there may be other factors that we have not taken into account that may explain the association between stress and disease risk. For example, sleep problems may be relevant – though they may also be part of the journey from stress to ill-health.

But equally it is possible that cumulative exposure to work stress is resulting in damage to employees’ physical health, which is then leading to disability and an early exit from the world of work. So, if we want to extend working lives then reducing work-related stress could be one of the keys to achieving that goal.

Allostatic Load and Effort-Reward Imbalance: Associations over the Working-Career, by José Ignacio Cuitún Coronado, Tarani Chandola and Andrew Steptoe, is published in the International Journal of
Environmental Reasearch and Public Health
.

Does education and job status affect the length of our working lives?

Who is most at risk of leaving work due to poor health? In a major international research project, Ewan Carr from the renEWL team has worked with colleagues at UCL, King’s College and Queen Mary University of London in the UK, INSERM and Paris Descartes University in France and the University of Turku in Finland to find out more about social inequalities and extended working life. Based on information from nearly 100,000 employees from seven studies in four countries, the research found employees with low levels of education or low occupational grade (e.g. unskilled or manual jobs) to be more likely to leave work for health reasons. While past studies have shown there is socioeconomic inequality in the ways that working lives come to an end, few have compared these trends across different countries.

Across Europe, ageing populations have forced governments to look at ways of extending working lives. As people stay healthier for longer, raising the state pension age has become a priority in a number of countries – in the UK this reform has already been implemented.

But this change is likely to be particularly challenging for those from lower socioeconomic backgrounds, who are known to lose both physical and mental ability more quickly as they age.

Planning for later life

There’s a double-bind here for this group. They’re more likely to be unable, through ill health, to continue to work in later life. But they’re also less likely to have the resources they need to keep them out of poverty in retirement.

People from lower socioeconomic backgrounds may have contributed less to their pension funds, and so may have to work even if they don’t want to, or if their health makes it difficult for them to do so.

Meanwhile those from higher socioeconomic backgrounds are likely to have bigger pension pots but also to have better health, which allows them to work for longer. They have a further advantage in that they are likely to have jobs they enjoy and which have more security – so they’re less likely to be forced into retirement or unemployment.

We wanted to find out more about this: would similar levels of poor health have a disproportionate effect on those who were less well educated, or who had lower-status jobs? If two people had the same health issues but had different social status, would one be more likely than the other to stay in work for longer?

Other studies have looked at these issues, but they had limitations. They tended to focus on single countries – or in some cases on the Nordic countries as a group – and weren’t necessarily applicable elsewhere. They often used things like disability benefit as a measure of work exit, and again these weren’t always the same from one country to another.

Work exit

Previous studies found people at both ends of the occupational ladder were more likely than those in the middle to extend their working lives, but for different reasons. Put bluntly, those at the top chose to continue working; those at the bottom were forced to do so.

We looked at data from seven independent studies in Finland, France, the UK and the USA. Some of these were drawn from representative samples of the whole population, while others looked at specific groups – for instance, the Whitehall II study in the UK followed a large group of civil servants over several decades. All the studies were based on people who were in paid work at around the age of 50. In total, our study covered almost 100,000 people.

We considered two measures of social status – level of education, and level of occupation. We assessed retirement age and route (i.e. whether it was for health reasons or not) using respondents’ own reports of their retirement as well as company and administrative records and benefits information.

Overall,wefound those with lower levels of education were more likely to leave work for health reasons – this effect could be seen for men in all the studies and for women in most. Lower occupational grades were also strongly linked to leaving work for health reasons.

These findings have important implications for policymakers, who usually calculate retirement age by sex but who don’t take into account factors such as family circumstances or social status. Policies which seek to extend working lives for all are likely to place those with lower socioeconomic status at a disadvantage – especially in countries where the benefits system doesn’t do much to help those who must leave because of ill-health. This study underlines a need both for greater flexibility in polices that extend working life and for greater recognition of the barriers faced by those from less privileged backgrounds.

Further information

Occupational and educational inequalities in exit from employment at older ages: evidence from seven prospective cohortsis research by Ewan Carr, Maria Fleischmann, Marcel Goldberg, Diana Kuh, Emily T Murray, Mai Stafford, Stephen Stansfield, Jussi Vahtera, Bowen Xue, Paola Zaninotto, Marie Zins and Jenny Head. It was first published in the journalOccupational & Environmental Medicine on March 12, 2018.

The studies used in the research were:

British Household Panel Survey https://www.iser.essex.ac.uk/bhps

English Longitudinal Study of Ageing http://www.elsa-project.ac.uk/

1946 National Survey of Health and Development http://www.nshd.mrc.ac.uk/

Whitehall II study http://www.ucl.ac.uk/iehc/research/epidemiology-public-health/research/whitehallII

Finnish Public Sector study, Finnish Institute of Occupational Health https://www.ttl.fi/en/

GAZEL cohort http://www.gazel.inserm.fr/en/

Health and Retirement Study http://hrsonline.isr.umich.edu/

Having a family – how might the decision affect the length of your working life?

Across the developed world, people are living longer. In response to this, governments are looking for ways to encourage people to work for longer. In the UK, the State Pension age is being raised and future generations will have little choice but to work. But how will the decisions they made earlier in life – whether and when to have a family – affect their later employment prospects? A new study from the RenEWL project by Dr Mai Stafford and colleagues at UCL and Queen Mary University of London has some answers.

Many of the post-war baby boom generation retired before the State Pension age began to rise. But subsequent generations must plan for longer working lives, and government policy needs to find ways to facilitate that.

We know more people are living longer, and we know that our decisions about having a family can affect the likelihood of us staying in work for longer. But we wanted to get a more nuanced view of how family and working lives can interact.

Would those who delayed starting a family until their thirties be more likely to work into their late sixties? How would those who never had children differ from those who did? And how would the prospects of women who took time out of the workplace be affected by that decision as they neared State Pension age?

We looked at data from the MRC National Survey of Health and Development (NSHD) which has followed the lives of more than 5,000 people born within a single week in 1946. Participants have been studied 24 times during their lives from birth, through childhood and adulthood, and most recently when they were aged 68-69 – at which point more than 2,700 people responded. The men in the study reached state pension age at 65; the women at 60.

We found that almost half the men had been continuously married with children and in full-time work since their early twenties. Women’s lives tended to vary more, with the largest group working full-time until their early twenties then taking time out to raise a family before working part-time and then returning to full-time work in their late thirties.

In their early sixties, just over two thirds of women and a third of men were not in paid work.

Women who did work at this age were more likely to be in part-time work, while men were more likely to be in full-time work. By the age of 68-69, just one in five men and one in 10 women were still in paid work.

 Work and family

Those who became fathers in their early twenties and who had jobs were more likely to be in full-time work at age 60-64 than men who remained single and childless. They were also more likely to be in work at age 68-69 than men who had partners and jobs but no children.

When we looked at how the age at which participants had their children affected their later employment, we found this made no difference for men. But women who had children later were more likely to be in full-time work at age 60-64 than those who had them earlier.

Having children early then returning to full-time work after a break, rather than continuous work through the childrearing years, made no difference to women’s later employment prospects.

We considered whether these differences might be driven by earlier health and socioeconomic circumstances that result in different kinds of family-work patterns. The links between work-family patterns and later life work participation remained when we statistically controlled for childhood health, educational attainment and childhood socioeconomic factors.

Why did the age of family formation make a difference? Women who have their children later may still be providing financial support to them in their sixties – though if so we would expect that men who had children later would also be more likely to be in paid employment, and this was not the case.

Women who became mothers later may also have started working later – possibly because they stayed in education longer – and therefore might have accrued less pension entitlement by age 60-64, though we do not think this fully explains the difference because we controlled for educational attainment.

British baby-boomers

So, what can this cohort of British baby-boomers tell us about how family decisions affect later working lives? We found that the timing of having children was related to women’s but not men’s employment in later life.

Both men and women who remained childless, regardless of whether they had a partner, were less likely to be in paid work in their sixties than those who had children.

And both men and women who worked full-time and neither had children nor a partner were also less likely than their peers to be still in paid work after the age of 60, though women in this group who were still working were more likely than men to be working part-time.

Mothers who returned to work were more likely to be in work in their sixties, while becoming a father made no difference to a man’s prospects.

It’s important for policymakers who have an interest in extending our working lives to consider these results. Mothers, and parents more generally, may stay in the work-force in later life if they have access to jobs which allow them to combine family and work. Our study underlines the need for both part-time jobs and flexible working to be available to parents.

Work–family life course patterns and work participation in later life is research by Mai Stafford, Rebecca Lacey, Emily Murray, Ewan Carr, Maria Fleischmann, Stephen Stansfeld, Baowen Xue, Paola Zaninotto, Jenny Head, Diana Kuh and Anne McMunn and is published in the European Journal of Ageing.

Never too early to intervene to get us working longer

Working for longer is something we are all having to get our heads around. It’s certainly a priority for the Government, which wants to encourage more older people into satisfying jobs that will help them stay happy and healthy as they age. For older people already in good jobs that they enjoy, who have been fit and active for most or all their life, this could be a great opportunity for them and their families. Of course that’s not the case for everyone. Dr Charlotte Clark has been looking at what having poor mental health as a child could mean for our working life in our mid fifties. Here she explains why policy makers and businesses need to pay close attention to the mental wellbeing of the nation if they want to extend people’s working lives successfully.

Working beyond traditional retirement age has been the focus of much attention in recent years as policy makers, businesses and working people across the UK get used to the idea that more of us need to work for longer to take account of the fact that more and more of us are living longer and that this reality comes at a cost.

As things stand, by their mid fifties, many people are not in work because of early retirement, long-term sickness or disability, being or becoming unemployed or because they are long term homemakers. So the onus for working longer tends to fall on those who stay employed through all or most of their lives. But could more be done to encourage and support those most likely not to be working at 55 to do so and then to continue to do so?

Looking right across people’s lives to track what may have influenced a person to leave or not be working at 55 provides us with a much clearer and more nuanced picture than a simple snapshot in time. We wanted to see whether having poor mental health as a child or as an adult might be an important part of that picture and give us some ideas for interventions that could extend the working lives of this group of people in a way that would benefit them and society more widely.

Increasing psychological support

It’s fair to say that the Government’s ambitions to get more people working for longer have been laid out quite clearly already, as has their commitment to putting people’s physical and mental health on an equal footing. Saying that, their commitment has been called into question recently in a report from The King’s Fund, which says parity is a long way off.

When it comes to specific groups not working, the Department for Work and Pensions has tended to focus its attention on benefit claimants rather than other groups who, for one reason or another may choose not to work – housewives and husbands for example.

Government initiatives to try to help people with mental health problems find work have included the ‘Improving Access to Psychosocial Therapies’ (IAPT) programme, which has increased provision of therapies for benefit claimants with depressive and anxiety disorders.

Evaluations of IAPT suggest that ‘Nationally, of [adult] people that finished a course of treatment in IAPT, 45% recover. . . and a further 16% show reliable improvement’. Encouraging results that have led to modest increases in employment, and it’s hoped there will be more positive news on this front.

However, things don’t look quite so encouraging when it comes to younger people with mental health problems and that’s what our research is shining a spotlight on. It’s also an area we believe should be a focus for policy makers and those working with young people including parents and schools. After all, successfully extending people’s working lives can only be done once they successfully enter and then remain in employment. This is less likely for youngsters with poor mental health.

55-year survey

We used information from the National Child Development Study which has followed the lives of thousands of people born in 1958, and collected detailed information about their lives and circumstances.

This included their employment situation and, first and foremost, we were able to see that, at age 55, nearly 19 per cent of the 9,000 participants in the study were not working: 2.8 per cent were unemployed, 5.2 per cent were permanently sick, 3.3 per cent were retired and 7.5 per cent were homemaker/other.

From a very young age, the study also collected information on whether the individuals in the study exhibited signs of depression or worry, whether they were hostile, disobedient or aggressive.

Even when we took account of a wide range of other things such as whether they suffered poor mental health as young or older adults, numbers of other children in the household, whether their partner was employed, qualifications etc. the association with problems as a child were still really strong.

Drilling down into whether those mental health issues were ‘internalized’ or ‘externalized’, we were able to see that those who were depressed or anxious as children were about one and a half times more likely to be unemployed or permanently sick as their peers without problems.

It was a similar story for those who had shown externalised signs such as aggression. They were more than twice as likely to be unemployed or permanently sick, and also more likely to fall into the homemakers/other category too.

Interestingly there was no strong link between poor mental health in childhood and taking early retirement or being employed part-time.

Children’s mental health

Of course there is a lot more at play in children’s lives than we have taken account of in this study. Nevertheless, it is clear from our research that addressing the mental health problems of the very youngest in society could and should be an area for focus and schools, together with parents and those with a responsibility for the wellbeing of young children have key roles to play here.

It seems it is never too early to intervene proactively to try to help young people get and stay on a healthy happy path that will lead to them a productive and satisfying working life that extends well beyond the age of 55. Equally, given that people identifying themselves as ‘homemakers’ rather than unemployed are the largest group not working at age 55, policy makers could consider ways to get this economically inactive group into the workplace, in tandem with its efforts to support the mental health of those people on benefits.

There is also a message here for policy makers about just how important it is to make those promises about parity of esteem between mental and physical health a reality sooner rather than later.

Impact of childhood and adulthood psychological health on labour force participation and exit in later life is research by Charlotte Clark and colleagues and is published in Psychological Medicine. The research is part of the ESRC funded Research on Extended Working Lives (RenEWL) programme at UCL.