Tag Archives: Retirement

Young woman sat by window

Are some types of job bad for your mental health? And how can employers ensure poor mental health does not lead to early retirement?

Mental illness is a major cause of early retirement – but do those who are forced to leave work early for this reason get better afterwards? What is the relationship between work stress and mental health? A new study of public sector workers in Finland suggests there is a link – and there are important lessons for employers. Tarani Chandola from the ESRC International Centre for Lifecourse Studies was among the authors of the study.

One way in which we can track the prevalence and level of mental illness is by looking at the use of psychotropic medication – that is, medication which can alter one’s mental state. This group of drugs includes common antidepressants, anti-anxiety drugs and antipsychotic medication. 

If there is a link between work stress and mental illness, then we should expect those forced to leave work for this reason to get better after retirement. So by tracking the levels of psychotropic medication among a group of workers before and after retirement, we could find out the extent to which there was such a link.

We were able to use data from a long-term study of Finnish public sector workers to examine the issue more closely. 

It matters because previous studies have shown an increase in the use of this group of drugs among all those who take disability retirement, particularly those whose retirement was due to mental ill health. Those from higher social classes saw the biggest drop in medication use after retirement, suggesting there are social factors at play here, too.

Global issues

The effect does seem to vary around the globe, though – some studies from Asia found an increase, rather than a decrease, in mental health problems after leaving work. But in Europe, retirement has often been found to be followed by an improvement in both mental and physical health. Retirees have reported sleeping better, feeling less tired and generally feeling a greater sense of wellbeing. 

We were able to use data from the Finnish Public Sector study cohort study, which followed all employees working in one of 10 towns and six hospital districts between 1991 and 2005. The study included participants from a wide range of occupations including administrative staff, cleaners, cleaners and doctors, and they were followed up at four-year intervals regardless of whether they were still in the same jobs. Their survey responses were linked to a register of medication purchases for at least two years before retirement and two years after.

We had information on 2,766 participants who took retirement because of disability. Uniquely, the data included both participants’ use of medication and their perceived levels of work stress. So we were able to ask whether there were differences in this pre and post-retirement effect between those in low and high-stress jobs.

Specifically, we looked at something called effort-reward imbalance – that is, when workers put in too much effort at work but get few rewards in compensation: according to a recent review, this carries an increased risk of depressive illness. 

If our theories were correct, we would see a decline in the use of psychotropic medication after disability retirement, and it would be greatest among those with high levels of effort-reward imbalance. Along with mental illness the other major cause of disability retirement in Finland is musculoskeletal disease, so we categorised our sample in three groups – mental illness, musculoskeletal disease and ‘other.’ Eight out of 10 in the sample were women, and three out of 10 reported high effort-reward imbalance before retirement.

Unsurprisingly, those who retired due to a mental disorder had the greatest increase in psychotropic drug use before retirement. And those who were in high-stress, low-reward jobs had higher levels of medication use than those who were not. But after retirement, there was no difference in psychotropic drug use between those with high vs low effort-reward imbalance. It looked as though stopping work in high stress jobs reduced the need for higher psychotropic medication use among those workers who exited the labour market for mental health reasons.  

Retirement because of musculoskeletal disease or other causes was not associated with any similar link between stress level and psychotropic medication.

Lessons for employers

Our study showed that among people retiring due to mental disorders, those in high-stress, low-reward jobs benefited most from retirement. So it’s likely that they could benefit from the alleviation of work-related stress before retirement, too.

In conclusion, if employers could find ways of reducing the levels of stress suffered by employees suffering from mental ill-health, their early exit from paid employment might be prevented and their working lives might be extended. 

Psychotropic medication before and after disability retirement by pre-retirement perceived work-related stress was published in the European Journal of Public Health, Vol. 0, No. 0, 1–6. 

The other authors were Jaana Halonen, Taina Leinonen, Ville Aalto, Tuula Oksanen, Mika Kivimäki and Tea Lallukka of the Finnish Institute of Occupational Health; Hugo Westerlund and Marianna Virtanen of the Stress Research Institute, Stockholm University; Martin Hyde of the Centre for Innovative Ageing, Swansea University; Jaana Pentti, Sari Stenholm and Jussi Vahtera of the Department of Public Health, University of Turku; Minna Mänty of the Department of Public Health, University of Helsinki; Mikko Laaksonen of the Research Department, Finnish Center for Pension.

These authors also have the following additional affiliations: Jaana Halonen; Stress Research Institute, Stockholm University; Jaana Pentti; Department of Public Health, University of Turku; Minna Mänty; Statistics and Research, City of Vantaa, Finland; Mika Kivimäki, Department of Public Health, University of Helsinki and Department of Epidemiology and Public Health, University College London; Marianna Virtanen, School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu; Tea Lallukka, Department of Public Health, University of Helsinki.

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.

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.

Can ‘nudge’ theory help extend working lives?

Government policy in the UK and other industrialised countries aims to increase the numbers of people staying on in work for longer – but there are significant differences between different groups. Can social and economic factors explain them? Or is there truth in the suggestion that some groups of workers are ‘resistant’ to staying in work, particularly in poorer areas? Nicola Shelton and colleagues from UCL looked at regional differencesin extending working lives and found policymakers may need to rethink their approach.

Despite the government’s stated desire for longer working lives, many workers still stop working before state pension age. The proportion of 60 year-olds in work in England and Wales is 20 per cent lower than the proportion of 50 year-olds, according to 2011 census data. 

And this drop in work participation rates isn’t uniform: Existing research tells us those with lower educational qualifications – particularly women –are more likely than others to leave work early.

So, why might that be?  Some official publicationshave suggested there may be resistance to continuing in work among some groups– perhaps in areas where there are fewer professional or skilled jobs, and where levels of deprivation and unemployment are high.

We wanted to find out more about this:  what regional differences are there in the age at which people leave work? Are there gender differences? Are there particular factors – working conditions, household or individual factors – which can promote extended working lives? And if there are, how do they affect any regional variations?  

There is some previous research on the subject. 

studyusing the ONS Longitudinal Study(ONS‐LS) and the English Longitudinal Study of Ageingfound those in lower-grade jobs, those previously unemployed, those with health problems and those with no dependent children tended to  stay longer in work, along with women from Pakistani or Bangladeshi backgrounds and single women. The study included just two areas, comparing the South, East and Midlands with the North of England and Wales.  

Similar evidence exists from other countries – In FranceNorwayand Great Britain, links have been found between unemployment and deprivation and retirement rates.

Census data

We used census data – a one per cent sample of the total population – to look at what happened to adults who were aged between 40 and 49 in 2001.  This ONS‐LS data covers more than 33,000 women and just under 32,000 men who were therefore aged 50-59 in 2011. 

We found men in the North East were significantly less likely to extend their working lives than others. Those in the South West and South East were 1.6 times more likely to stay on than those in the North East, in the East of England 1.5 times, and in the East Midlands 1.4 times. 

Women in all regions apart from London and Wales were significantly more likely to stay in work than those in the North East, with figures ranging from 1.15 times in the North West and West Midlands to 1.6 times in the South West.

But when we did further analysis, we found that for men at least, other social factors could explain these differences. Put bluntly, the reason men in the North East leave work earlier is because they tend to have fewer qualifications and less favourable employment status – both of which are associated with shortened working lives.

When we did the same analysis for women, we found some additional factors which affected their likelihood of staying on in work. Those in lower-skilled jobs were less likely still to be in work by 2011, along with those working for larger employers. Those who worked away from home were also more likely to have left, along with those who worked long hours. 

And again, – when we considered these factors along with prior employment, health, social status and caring responsibilities, and only those in the South West were significantly more likely to stay on than those in the North East. 

Working conditions

So, what can governments do? Given a good work environment, choosing to remain in work may have positive benefits such as maintaining good health and functioning and providing a sense of purpose- so working conditions are important.

The biggest single factor in determining whether workers stay on for longer is prior employment – and that is not likely to be changed by behavioural approaches such as the ‘nudge’ theory of behavioural economics which is popular with policy makers.

Policies that do not address issues such as low levels of education and high levels of unskilled employment can only be partially successful in enabling people to work for longer. Indeed, some groups who may have the most financial need to remain in work are most likely to leave earlier. This is particularly an issue for women.

Policies that increase skills and education in later life, rather than simply targeting those ‘receptive’ to extended working, will be more likely to make a difference.

Gender differences and individual, household, and workplace characteristics: Regional geographies of extended working lives, is research by Nicola Shelton, Jenny Head, Ewan Carr and Paola Zaninotto, and is published in Population Space and Place. 

Working with a long-term illness – does employment status make a difference?

Across the developed world, a growing share of the population suffers from chronic disease such as diabetes, arthritis or heart problems – in the EU, around 45 per cent of those aged 55-64 had such a disease in 2015. And that affects their ability to work: just half of those with chronic illnesses are employed, compared to three quarters of those without. But how do the self-employed cope with such conditions, when compared with those in employment? Maria Fleischmann and colleagues from the RenEWL project find these differences in work status can make a major difference.

We know that when people become chronically ill, changes in their working conditions can help them to continue working. And we also know that good working conditions – being able to control how you use your time and how you do your job, whether you make the decisions and whether you feel valued, for instance – can help all of us to stay in paid work for longer.

And of course, if you become ill you’re more likely to feel the need to take time off or maybe to give up work altogether. We wanted to compare how the employed and the self-employed adjust their working conditions when facing a diagnosis of chronic disease.

Existing research tells us that many older people work for employers, and have to ask for their approval when it comes to making adjustments to their working conditions. The self-employed, meanwhile, are much more able to make their own decisions and tend to feel they have more control over their working lives.

We looked at people’s ability to control their work: physical demands, working hours, psychological demands such as how fast they had to work, and social aspects such as whether they felt valued.

And we had a great source of data for this – the English Longitudinal Study of Ageing (ELSA), which has followed a total of almost 9,000 over-50s since 2002.

From that group we were able to find and study 1389 participants who reported no chronic diseases when they were interviewed in 2004-5 – the second wave of interviews – and who were in work.  We were then able to look at what happened to them before the seventh wave of interviews, in 2013-14.

A little over 40 per cent of our sample were in managerial or professional occupations, a quarter in intermediate occupations, and almost 30 per cent in routine and manual occupations.

After diagnosis

At each interview, respondents were asked whether they had been diagnosed by a doctor with lung disease, asthma, arthritis, cancer, high blood pressure, diabetes or high blood sugar, stroke or heart problems.

During the study period 510 of the 1389 sample members were newly diagnosed with one of those conditions. We were able to look at how they fared at work for four years after that, and we found some striking differences between how the employed and the self-employed seemed to have been treated.

The physical demands of our participants’ jobs were pretty similar before their diagnosis, for instance. But afterwards significant numbers of those who were employed said that those demands had actually increased when they were diagnosed. The self-employed, meanwhile, told us the opposite had happened to them – they reported significantly lower physical demands at work immediately after diagnosis. This effect continued for some time, though it grew less pronounced.

How could that be? We think maybe the increase in physical demands among the employed could be due to perception – similar demands might be perceived as more strenuous by the chronically ill. The self-employed, meanwhile, have more freedom to adjust those demands when they feel they need to.

The self-employed reported that their working hours dropped by an average of 2.8 hours per week on diagnosis, while those who were employed did not see a change. This effect was not statistically significant, though.

Employees found that their level of autonomy at work also dropped marginally, while for the self-employed there was no significant change. We did not find any major changes in psychological or social conditions in either group.

So, what did we learn? Essentially, that improvements in working conditions after diagnosis of chronic illness were restricted to the self-employed. So employers may need to ask themselves some hard questions – do they want to hold on to workers who become unwell? If they do, then they should consider the levels of flexibility they offer, and they should think about making adjustments for those workers if they don’t want to lose them.

In an ageing society, older people are expected to work ever longer and therefore to remain at work even when they begin to suffer from health problems. Our findings should also encourage policy-makers and governments to think about how chronically ill older adults are treated at work.

Changes in autonomy, job demands and working hours after diagnosis of chronic disease: a comparison of employed and self-employed older persons using the English Longitudinal Study of Ageing (ELSA)by Maria Fleischmann, Ewan Carr, Baowen Xue, Paola Zaninotto, Stephen A Stansfeld, Mai Stafford and Jenny Head, is published in the Journal of Epidemiology and Community Health.

 

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.

Working after retirement age: who benefits?

Recent reforms have made it unlawful for employers to force their workers to retire. So what are the reasons why some people stay on after state pension age while others choose to leave? How do those decisions affect quality of life for those who stay, and for those who go? A study by Giorgio Di Gessa and colleagues at King’s College London and the University of Manchester sheds new light on the issue.

We know that more of us are working after we reach retirement age – but until now we haven’t known much about how people make that decision, or about what effect it has on their sense of wellbeing afterwards.

In our research, we used English data from a panel study of older people to find out more about who chooses to stay on in work and why. We then went on to ask whether those who chose to work felt differently about their lives when compared with those who felt they had to work.

We took a representative sample of 2,500 men aged 65 to 74 and women aged 60 to 69 who had previously been in work, and we found one fifth of them still had paid jobs. Of those, two thirds had chosen to continue to work because they enjoyed their jobs or because they wanted to keep fit and active. The other third said they worked for financial reasons: either they couldn’t afford to retire or they wanted to improve their pension provision for later.

We placed the retired respondents into three groups: Those who had had a ‘normal’ retirement when they became eligible for a state pension (28 per cent), those who felt they had to retire because of ill-health or redundancy (2 per cent); and those who retired voluntarily – because they could afford to do so or because they wanted to spend more time with their family, for instance (28 per cent).

Quality of life

On average, those who had retired experienced a lower quality of life, when measured on the CASP-19 scale for older people. The highest quality of life was reported by those who had stayed in work voluntarily, while the lowest was reported by those who had retired involuntarily. The gap in quality of life between these two groups is similar to the one observed between respondents who said they had a long-standing illness and those who did not. As expected, respondents who were financially better off also had higher quality of life scores.

When we considered changes in these CASP-19 scores over time, we found that on average people experienced a drop in their quality of life over a six-year period between two ‘waves’ of the study: about a quarter experienced a decrease of 5 points or more whereas just over 16% experienced an improvement of 5 or more points. Those working voluntarily experienced a slight increase in their quality of life when they eventually retired. On the other hand, the wellbeing of those who were working out of necessity did not improve after retirement.

Health benefits

As one might expect, the scores improved among those whose health got better after retirement, and worsened among those whose health deteriorated.

It’s worth noting that our study sample is skewed towards the more advantaged – the proportion with no qualifications is significantly lower than in the census. It is therefore likely that our study underestimates the percentage of people who work out of financial necessity.

What does our study tell us about working after retirement age? In particular, it reminds us how important it is for people to feel they have control over these key decisions about their lives. Those who continue working because they have to have lower quality of life than those who continue working because they want to – and even once those people have retired, this wellbeing gap is likely to persist.

We know that people who experience a higher quality of life tend to be healthier and to live longer.

Government initiatives aimed at helping workers maintain control over their decisions are worthwhile – but policymakers should also consider how people might be given more support throughout their lives to protect their financial and personal wellbeing if they do have to work for longer.

Further information

The decision to work after State Pension Age and how it affects Quality of Life: Evidence from a 6-year English panel study is a research paper by Giorgio Di Gessa of King’s College London, Laurie Corna of King’s College London, Debora Price of the University of Manchester and Karen Glaser of King’s College London. It is published in the journal Age & 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.

 

Staying at work longer – a matter of geography?

There are lots of reasons why people end their working lives early, and the relationships between those reasons are complex. We know, for instance, that if you’re a carer for someone close to you, if you’re unwell yourself or if you don’t have higher level qualifications then you’re more likely to stop working sooner. But how does the area in which you live affect your prospects of working for longer? What if you live in an area of high unemployment, for instance? A new report by George Holley-Moore and colleagues at the International Longevity Centre – UK highlights how people in such areas are less likely to extend their working lives – even when those other factors are taken into account.

All too often the debate about how best to help people to work into later life stops at physical health. But research from the renEWL project suggests there is much more to be considered. In a new report, Working for Everyone – Addressing Barriers and Inequalities in the Working Lives Agenda, we look at these complex relationships – and we find there’s a great deal more policymakers could be doing to help.

Interlinking factors such as physical and mental health, working conditions, family life and lifestyle are all important. And it’s vital that regions should use their devolved powers to ensure that people in all parts of the population have the opportunity to extend their working lives.

The importance of geography

But how does where you live affect the length of your working life? We know older workers living in areas of high unemployment tend to leave work earlier: A study by Emily Murray and others looked at a one per cent sample of the population, aged between 40 and 69 and working in 2001, and at the same sample again 10 years later. Using local area statistics on unemployment, it mapped whether they left work, and their reasons for leaving, against the level of joblessness in their area.

It found that people who rated their health as poor in 2001 were almost six times more likely not to be in work 10 years later.

Thinking about this, it’s perhaps unsurprising that older workers in areas of high unemployment were less likely to be in work 10 years on – after all, if you live in an area with high unemployment you’re more likely to suffer from a long-term health issue. And that’s bound to affect your ability to work. Furthermore, if you have poor health earlier in life you are more likely to be sick or disabled later in life.

But was there a geographical factor even after these health inequalities were taken into account? Murray and colleagues found that even those in good health were more likely to be out of work a decade on if they lived in an area of high unemployment – that is to say, this economic factor operates separately from all those other things that can affect the length of a person’s working life. People in poor health were more likely to be out of work regardless of where they lived.

Evidence-based planning

It’s clear that there is a need for strong regional and national planning on these inter-related areas of work, health and geography. Creating policies tailored to the unique pressures faced by the local population will be necessary to address the scale of the problem:

National Government should focus infrastructure spending on areas of higher unemployment with a view to increasing job opportunities and making employment more accessible for older workers.

Regions need to use devolved power to tailor their own integrated strategies to enable fuller working lives.

Local authorities should be given power and funding to coordinate local partnerships that tackle employment challenges. These should include councils, businesses, health and social care providers and charities: supporting fuller working lives in at-risk areas would require a joined-up approach that targets the various at-risk groups.

Fundamentally, policy must move away from focusing exclusively on physical health conditions. We need a holistic approach which incorporates physical and psychological health, growing care needs and socio-economic disparity if we are to extend working life for everyone.

 

A question of support: working longer and what works

As more of us work for longer, it’s important to recognise the needs of older workers: and that includes the fact that as we age we are more likely to suffer from long-term illnesses. To what extent do our working conditions affect our decisions about whether or not to continue in a job despite having a chronic disease? Maria Fleischmann, research associate in the Department of Epidemiology and Public Health at University College London, has been asking what might help to prolong working life for older people. Could factors such as having supportive colleagues and managers, or a clear understanding of who does what, make a difference?

There is strong evidence that people with long-term illnesses leave work early. While three quarters of healthy European 50-somethings have jobs, the figure from those with chronic disease is much lower. Among those with one condition such as diabetes or heart disease, the employment level is around 70 per cent – and for those with two or more that drops to around 50 per cent. Conversely, those who are able to stay well are significantly more likely to continue working beyond pensionable age.

As our working lives grow longer, it’s important to acknowledge that older workers with chronic diseases may have different needs from those who are well – they may not be able to work such long hours, for instance.

So, what are the factors that can make a difference? We know, for instance, that people are likely to remain in work for longer if they have a high level of control over their own hours. Shift workers, on the other hand, are more likely both to become unwell and to leave work early.

Deciding to stay on at work

But what about the factors that are harder to see? What about a worker’s sense of his or her own job stability, or of how harmonious the relationships are between co-workers? Does it help if an employee feels he or she generally knows who does what, or how to respond to a given situation? These types of factors – collectively known as ‘psychosocial factors’ – are also believed to affect peoples’ decisions about whether to stay on at work.

We used data from the Whitehall II study, which has been following the lives, work histories and health experiences of just over 10,000 London-based civil servants since the mid-1980s, when they were all aged 35-55. We looked at the participants in mid-life, around 14 years before retirement age, to see how factors such as levels of autonomy and of support from supervisors or co-workers might affect their decisions if they became ill with diabetes, coronary heart disease, stroke or malignant cancer.

And we found that while good ‘psycho-social’ working conditions were helpful generally in supporting workers to stay on in their jobs, they didn’t appear to make any extra difference for those who became ill.

The participants in the Whitehall II study were asked questions such as: ‘Do you have to do the same thing over and over again?’ and ‘Do you have a choice in deciding how to do your work?’ They were also asked whether they felt they had good support from colleagues and superiors and how demanding they felt their job was. They were also asked to describe their level of education, their mental health and whether they had a partner who worked.

We were able to use their answers to assess whether these factors made a difference when they developed illnesses later in life.

Chronic illness

We could see that six out of 10 participants left work between the first phase of the study in 1985 and the last one used for this study, in 2007-9. During the same period the proportion suffering from chronic illness had increased from less than two per cent to almost 30 per cent.

So why had they left, and how might those ‘psychosocial’ working conditions have affected those decisions?

Among the whole group of participants, we found clear evidence that those who felt they had reasons to be happy in their work were more likely to stay on. Specifically, those who felt they were using a wide range of job skills – known as skill discretion – and those who felt they had good social support at work were more likely to stay on for longer.

However, we did not find evidence that those ‘psychosocial’ factors would make more of a difference in whether or not a worker stayed on if he or she were chronically unwell. Or rather, good working conditions were equally important for workers both ill and well.

So, we know that good social and psychological conditions at work are likely to be helpful in keeping employees at work as their careers near their end. And we know that chronic illness is a major reason why people leave work early. But from our study, we cannot say that such good working practices will be a particular deciding factor for those who become unwell.

How and why people leave work

There were some interesting factors in our results: first, we were able to look at the different ways in which people left their jobs, and the reasons why they did so. So those who used a wide range of skills had a reduced risk of leaving work earlier through retirement or ill-health, but this was not related to the risk of leaving work earlier through unemployment; while those who had good social support had a reduced risk of leaving earlier through ill health or unemployment, but not so much when we looked at leaving earlier through retirement.

And while previous studies had tended to measure working conditions at the time of leaving, ours looked at those conditions several years beforehand.

There is certainly scope for more detailed research on this issue – and there is plenty of reason for both researchers and policy advisors to continue to focus on how employers can help chronically ill workers to stay in their jobs.

Can favourable psychosocial working conditions in midlife moderate the risk of work exit for chronically ill workers? A 20-year follow-up of the Whitehall II study is research by Maria Fleischmann, Ewan Carr, Stephen A Stansfeld, Baowen Xue and Jenny Head. It is published in the BMJ Journal of Occupational and Environmental Medicine and is part of the renEWL project on Extended Working Lives.