Tag Archives: Unemployment

Lockdown – just how stressful has it been?

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2020 is a year many will be happy to see the back of. It has been a stressful time for sure with periods of lockdown creating major challenges for our day to day work and family lives. But have the stresses and strains associated with lockdown affected the mental health of the UK population as a whole? Tarani Chandola and colleagues have been using specially collected COVID19 data to investigate.

On March 23, the UK found itself in its first lockdown, a direct result of rising infection rates and deaths caused by the pandemic. The new normal for many was working from home whilst trying to homeschool children. The weekly shop involved queues and masks and social distancing. Getting a doctor or dentist appointment or scheduled medical treatment took on a whole new dimension. Trips to the pub, cinema and theatre were things people could no longer look forward to and looking out for elderly relatives and friends became more important and challenging in equal measure.

Gradually through the Summer months, many of these restrictions were eased and the majority of children returned to school. Businesses including pubs, gyms and hairdressers were able to re-open albeit with strict social distancing and hygiene measures in place.

The severity of the restrictions combined with the direct effects of the disease itself created what might be described as a perfect storm of increased potential stresses likely to adversely affect the mental health of people everywhere. Most of us will have felt fearful about catching the disease, and many will have experienced additional worries for already vulnerable family and friends. The realities of working at home brought its own challenges while for others being furloughed or losing their job brought additional anxiety. 

Although there have been widespread reports of worsening mental health and wellbeing through the first UK lockdown, there have also been some reports that this eased somewhat through April and May although not back to pre-pandemic levels.

COVID-19 data

In our research, which made use of data from Understanding Society including its specially-collected COVID-19 study, we were able to look across a slightly longer period of time at the experiences of between 13,000 and 17,000 people in the UK. These were people who had been involved in the survey for many years, so there was a great deal of background information available as a backdrop for our research. 

We wanted to see whether more people were reporting struggling with mental health problems and to what extent the prevalence of problems was directly related to the stresses and strains of lockdown and the pandemic specifically. We also wanted to see if, after the initial ‘shock’ of events in April eased in subsequent months as people began to adapt and ‘get used to’ their new circumstances.

Between April and July study participants were asked a range of questions directly related to the disease itself including whether they had had it, been tested for it or experienced symptoms. There were also questions about any other health treatment, their families, work and money- related concerns such as struggling to pay the bills.

Every month people were asked about their work status so we could see for example  who was employed, self-employed, working reduced hours, furloughed or been made redundant. They were also asked about hours spent on childcare and homeschooling or whether they felt lonely.

Common mental disorder

Before lockdown just under 25 per cent of people in the UK had experienced mental health issues and this rose to just over 37 per cent in April, so more than a third of the population. There was a gradual dropping off of cases through to July (just under 26 per cent) taking things almost back to pre-lockdown levels. 

The percentage of new cases of mental health problems among participants in April was double (around 28 percent) what it was in the preceding 12 months.

And recovery rates from a mental health issue dropped from pre-lockdown months through April to June but picked up again in July, by which time social restrictions had been eased considerably and, our research shows, potential stressors around COVID itself, juggling work and family responsibilities and health, business and money concerns had decreased for most.

The number of people who reported having some sort of health limiting condition and having to cancel or postpone medical treatment halved from April to July. Over the same period, the number of self-employed people who said their business had been adversely affected also went down from 3.6 percent to 0.6 percent. Employees who reported being made unemployed or being on reduced hours also more than halved and there was only a small increase in the proportion of people describing themselves as ‘economically inactive’. 

Rates of reporting ‘often feeling lonely’ went down from 8.8 to 6.7 percent and fewer people reported having to spend more than 16 hours a week on childcare or homeschooling although there was a small increase in the proportion of people spending 1-15 hours on those tasks.

For some people, problems with paying bills remained an issue throughout the period,  although the percentage of people who said they found things very difficult financially or who said the future looked bleaker financially reduced somewhat from April onwards. 

Which stresses affected people most?

The strongest link between lockdown related stress was loneliness. People in the survey who reported ‘often feeling lonely’ were 11 to 16 times more likely to have mental health problems from the April to July compared to those who never felt lonely. Other important stressors were having COVID-19 symptoms and always working from home. 

Self-employed people whose businesses were negatively impacted by COVID-19 were more likely to develop a mental health problem compared to their peers whose businesses were not. And by July, employees who became unemployed, or were made redundant or whose work hours were reduced were over two times as likely to develop a problem compared with those who were unaffected. 

Adults doing16 hours or more a week on childcare or home schooling were about 1.4 times more likely to develop a problem compared to those who had no children or did not spend any time on childcare. 

Adults who were finding it quite or very difficult financially were 2.4 times more likely to develop a mental health issue compared to those who were living comfortably. Similarly, adults who expected their future finances to be worse off than now were 1.6 times more likely.

Longitudinal analysis

Our findings from looking at this group of people across April to July are in line with other surveys undertaken by the Office of National Statistics and the UCL COVID-19 study of 90,000 adults. We add to that picture by looking more closely at which stressful circumstances are most likely to drive up incidences of poor mental health during a pandemic of this nature. 

We conclude that despite the lifting of many lockdown conditions by July and a decrease in the levels of many of the psychological and social stressors, these stressors continued to drive poor mental health among people who were lonely and those who were made unemployed or redundant, had financial problems or had childcare or home schooling duties.

As unemployment and redundancy increase in the labour market, an inevitable result of recent events, it will be important to keep monitoring the mental health consequences of unemployment. It is Interesting also to note that employees who were furloughed had about the same levels of mental health problems as employees whose job hours were not affected. This suggests that the government measures to protect jobs also had positive mental health benefits for those employees who were able to keep their jobs albeit in a “furloughed” state.

The mental health impact of COVID-19 and lockdown-related stressors among adults in the UK is research by Tarani Chandola, Cara Booker, Meena Kumari and Michaela Benzeval and  is published in Psychological Medicine

Constriction worker

Is temporary employment bad for your health?

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How is the health of those in insecure jobs affected by their working lives? Rachel Sumner and colleagues* have discovered some types of work may be just as strongly linked with poor health as unemployment is.

It’s long been acknowledged that there’s a link between unemployment and poor health. A recent Government Green Paper put it starkly:

“People who are unemployed have higher rates of mortality and a lower quality of life. This is an injustice that we must address.”

But is any job really better than no job? Or could some types of employment actually be linked just as strongly to poor health?

We looked at the issue using data from the Understanding Society study, which took blood samples from more than 4500 people aged between 16 and 64 who were either working or unemployed in 2010 and 2011– we excluded those who were retired, homemaking, not working due to incapacity or in education.

Overall, 7.6 per cent of our sample were unemployed. Amongst the employed, 81.8 per cent were permanently employed, 5.3 per cent were temporarily employed and 12.9 per cent were self-employed.

Health indicators

These samples were used to show whether the study participants had raised levels of fibrinogen or C-reactive protein (CRP), both of which are inflammatory markers and are associated with increased risk of heart disease. Healthy lifestyles decrease CRP levels, while obesity, physical inactivity and smoking increase them.

We compared the levels of these markers in those who were unemployed, permanently employed, temporarily employed and self-employed. We took into account a range of individual, social and health factors which might also influence the levels of these markers.

We didn’t find links between employment status and levels of CRP – but we did find links with fibrinogen.

We looked at how the levels of fibrinogen in different types of employee compared with those who were unemployed. And while those in permanent jobs or self-employed had lower levels of this marker, those in temporary work had similar levels to the unemployed.

So, not all types of work are equally beneficial in health terms – and in particular, temporary work would seem to be linked with worse health than other types. Indeed, in health terms we may actually be just as well off being unemployed as we are in an insecure job.

Why does this matter? It matters because less stable types of employment have grown in recent decades, with many workers employed on fixed-term contracts and experiencing uncertain job conditions. This has already been shown to have negative psychological consequences.

And since the recent global recession, which happened just before our data was collected, both unemployment and temporary employment have expanded. The European Union has a higher temporary employment rate than the OECD average  – 14.2 per cent compared with 11.2 per cent in 2016.

Levels of temporary employment in the UK are lower than the EU average – just six per cent in 2017 and four per cent in 2019  – but temporary employment has become more common since the financial crisis, particularly among young people. The rate of young people in the UK going into precarious employment has already resulted in poorer mental health.

Lessons for policymakers

If temporary employment is associated with an increased risk of mortality then earlier research which has simply compared unemployment with employment has not captured the complexities of the situation.

In conclusion, our findings would suggest there is little difference between the health effects of temporary employment and unemployment, using these particular indicators.  And given the continuing rise of precarious modes of employment across developed countries, this has significant implications for public health. Policymakers should encourage employers to expand the use of permanent contracts.

Unemployment, employment precarity, and inflammation, by Rachel C. Sumner, Rachel Bennett, Ann-Marie Creaven and Stephen Gallagher, is published in Brain, Behavior and Immunity.

Rachel Sumner and Rachel Bennett are based at the School of Natural & Social Sciences, University of Gloucestershire, United Kingdom; Ann-Marie Creaven and Stephen Gallagher are at the Health Research Institute, Department of Psychology, University of Limerick, Ireland.

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.

Can ‘nudge’ theory help extend working lives?

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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. 

A 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 France, Norwayand 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. 

Early retirement – can welfare systems help ease the transition?

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The post-war ‘baby boom’ generation 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 haven’t 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 it’s 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, 1–13.

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

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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/

Staying at work longer – a matter of geography?

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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

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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.

Unretirement: can it be a positive story for all?

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“When I was sitting around at home I would just get grumpy. I’ve also lost five stone since working here. This is like a vitality camp for me.” Retired British Transport Police inspector Brendan McCambridge, 56, interviewed in The Telegraph, describes how his new role at Waitrose has improved his life. He is one of the one in four retired British people who return to paid work, a phenomenon called “unretirement”. New research, led by Dr Loretta G. Platts from Stockholm University’s Stress Research Institute, explores who ends up unretiring. In this blog post, she considers the implications for individuals, business and policy of retired older people returning to paid work.

Retirement can be an abrupt and one-way change marking the end of paid work and the start of a time of leisure. But people’s lives often don’t look like this. People may gradually retire over a period of time, or even unretire, returning to paid work after retiring. We found that around one in four retirees in the UK returns to paid work, mostly within five years of retiring.

Our information came from the longitudinal Understanding Society data and its predecessor the British Household Panel Survey. We followed more than 2000 50–69-year-olds through the 1990s and 2000s. Participants were defined as unretiring if they reported retiring and later returned to paid employment, or began full-time work following a period of semi-retirement.

While all sorts of people unretire, men are more likely to unretire than women, as are people in good health and those with post-16 qualifications. Unretirees are also more likely to have a partner in paid work. After ten years, a retiree’s chances of taking up paid work are low.

What motivates unretirement?

Unretirement was a positive experience for Brendan McCambridge. Having a job helps to stay mentally and physically active, provides a meaningful activity, and unretirees often appreciate the social side of paid work. Some may appreciate the extra money earned which supplements a pension and provides funds for little extras. For others, earning money is an important part of the decision to unretire.

Our findings suggest that financial factors play a role in the decision to return to paid work. Retirees paying off a mortgage are more likely to unretire than those who already own their home outright. Unretirees may wish to prepare financially for retirement or to supplement a pension. With a basic state pension of £122.30 per week for people who retired before 6th April 2016, some people may have found a new job because they could not afford to retire.

Former Pensions Minister Steve Webb, now director of policy at Royal London, contends that some retirees may have little other option than to get a job. In an interview for People Management, Webb noted that although many of those heading back to work after retirement do so because they “miss the stimulation and social contact”, there is a “real danger” that a whole generation of people will be unable to retire in the first place because they have not managed to save a big enough pension pot.

He says: “If employers do not address this issue they could find themselves with an unhappy older workforce that does not want to work but cannot afford to stop.”

Why retire and then unretire?

Some people may unretire as a result of finding out that they like being retired a lot less than they thought they would. Researchers call this a “retirement shock”, in which recent retirees, just like Brendan McCambridge, discover that they do not like their new lifestyle.

Others may have known all along that they wanted to remain in paid work, but were unable to. More than one million people over 50 are out of work for reasons beyond their control and would like to be in paid work if the appropriate opportunities were available. Some people may be forced out of work directly or indirectly as a result of age-based stereotypes, in particular through not being offered training programmes to learn new skills, or from their updated skills being undervalued.

In their second Missing Million report, Business in the Community has argued that far too many older people are being denied the chance to enjoy meaningful employment in later life and calls for stronger age discrimination legislation to tackle this.

Employers of older people also often deny them the flexibility they require to stay in paid work. Workers aged between 50 and 69 years are more likely than other age groups to want to work fewer hours than they currently do, even if this were for less pay. Around 8 per cent of workers in their 50s are working more than 45 hours per week while also being in ill health. Such older workers, locked into working long hours, may retire from jobs because they do not offer sufficient flexibility of working times.

Retirees may then take a more suitable job if it comes up, or negotiate more suitable working times later on if their former employer asks them to come back. Dr Jill Miller, diversity and inclusion adviser at the Chartered Institute for Professional Development believes that simple adjustments to working times or job roles could be the key to employers attracting and retaining a “significant talent pool” of older workers who can contribute to the success of the organisation.

Does everybody get to unretire if they want to?

While people in financial straits may be wanting to unretire, we found they did not necessarily manage to. People who were struggling to make ends meet were not more likely to unretire than people in a more comfortable financial situation.

Similarly, those who had lower earnings before retirement were not more likely to unretire. The reason is probably that it is harder for people in a precarious financial situation to find a suitable or good quality job.

These findings are worrying in terms of the broader picture of inequalities in later life. If those retirees who most need to supplement their incomes in later life are not able to find suitable paid work, unretirement may be part of processes that increase inequalities in income between older people.

The findings are also worrying in the context of skills shortages currently faced by British industry, which are predicted to be exacerbated over the coming years. By 2022, the skills gap is expected to reach 7.5 million vacancies. Government and business should not forget about the experience and skills of recently retired workers who are often ready and keen to be re-engaged in the workforce. These workers may need more support and legislation to protect and promote their rights to work more flexibly to take into account their preferences and also the fact that they may be caring for grandchildren and other family members.

Specifically, the government could improve flexible working legislation by providing employees with the right to request flexible working from the start of the job application process, rather than waiting 26 weeks from the beginning of employment. Since older employees are less likely to be offered training, and are less likely to take it up, employers could monitor access to training and development by age as well as proactively offering training to employees and being open to additional training requests.

Where older people manage to find new jobs, it is a result of their own efforts and networks, and not because they accessed effective support. Older people reported in focus groups that Job Centres in particular provided poor guidance and assistance. Government could consider how to develop age-appropriate support services and guidance in Job Centres. Both government and employers could offer mid-life career reviews.

In the long term, we need to work towards a society in which unretirement becomes a positive story for all. Business and wider society stand to benefit from the ambition, experience and skills older people bring to the labour market. For financial and other reasons, many older people want to be in paid work. Currently, they are all too often left out.

Returns to work after retirement: a prospective study of unretirement in the United Kingdom is research by Loretta Platts, Laurie Corna, Diana Worts and Peggy McDonough and is published in Ageing and Society.

Photo credit: Scott Lewis

Downshifting and long-term part-time work could be key to a healthy retirement

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A secure, comfortable and healthy retirement is something most of us aspire to. But, as we live longer, we are all being encouraged to work later, increasingly well into our late 60s, so what might that mean for those aspirations, particularly the desire to be fit and healthy? Whilst the number crunchers have done their homework about how the sums add up around the available money to support more retired people for longer, very little is known about how working longer will impact on our health and what the knock on personal, societal and economic costs of that might be. Peggy McDonough at the University of Toronto, together with colleagues at UCL and Kings College, has been using US data to get a clearer picture of what the latter part of working life and health look like for men and women. Here she explains the research and why flexible working policies, particularly those concerning part-time work, could be key to ensuring a healthy retirement is a reality as well as an aspiration.

Across the developed world falling birth rates and the so-called ‘baby-boom’ cohort’s retirement have raised the spectre of unsustainable State pension costs. This has led to a range of reforms, many of which have seen a rise in the age at which we can collect State Pension. In the UK in 2020, men and women will have to wait till they are 66; this will rise to 68 by 2028. In the States, the age will be 67 in 2027. In addition, other incentives to work longer and disincentives to take our pensions earlier have been trialled or introduced.

What we don’t know much about is what the health consequences are of stepping up the workplace participation of older adults. Will working longer make our health better or worse? And what if those consequences undermine other social and economic goals, such as those around wellbeing and inequality? In addition, are there differences in the way these things play out for women and men?

Research to date has tended to focus on retirement as an exact or single point in time, which doesn’t necessarily reflect the more complex things happening during the run up to and after retirement. Findings are also ambiguous and it’s not clear whether retiring early, partial retirement or working longer is generally associated with better health.

Our research looks across a much longer period, viewing retirement more as a project that unfolds over time and drilling down into what is going on as we move from the ‘family- and career-building years’ to the ‘frailty years of old age’. This way we hope to get a better and more nuanced picture of how our work and our health interact over this part of our life and get some pointers about what seems to work best when it comes to staying as healthy as possible into the Third Age.

Patterns of work

Our data come from the Health and Retirement Study, which has collected information from more than 25,000 Americans aged 50 + since 1992. Working with the original cohort, all of whom were born between 1931-41, we examined the working lives and health of some 6,500 men and women over 18 years.

It was interesting to see that only 14 per cent of the men in our study followed a ‘conventional’ path involving full-time work until retirement at around 65 years of age. More of them (21 per cent) acted in line with recent policy initiatives and worked longer or did the complete opposite and retired in their early 60s (18 per cent). Slightly less than one in ten men stayed working but shifted from full to part-time work; it was rare for men to have had a substantial period of the time in part-time work.

Less than half as many women (10 per cent) worked full-time throughout the period. They were three times more likely than the men in the study to have worked part-time from the outset. The largest proportion, double that for men, was not working across this period, but, if they were, they were more likely to retire around the age of 62 than 65.

Health at 70

 When we took into consideration a range of other background factors, like education, income, marital status, and minority background, we could start to get a picture of the most ‘advantaged’ people in terms of health.

One group of men stood out: those who downshifted from full-time to part-time work around age 65 had the lowest chance of being in poor health at age 70. Women were slightly different: being in work (either part-time or full-time) was associated with the best health, as was retiring in the early to mid 60s. Women in long-term part-time work were especially advantaged.

At the other end of the spectrum, men retired early or worked very little in middle age were more likely to have poor health than others. The same was true for women.

 Downshifting is key for men; long-term part-time work, for women

Whilst it was interesting to note that long-term part-time work for men was not linked with better health for men when it was for women, we think that is probably because for this generation, women (traditionally caregiver) would have perhaps engaged in part-time work through choice, whilst for men (traditionally breadwinner) the reason may have been linked to earlier poor health.

Our research certainly provides a more detailed picture of how people’s working lives pan out in their fifties and sixties and shows quite clearly that men who are able to shift to part-time work in their 60s are most likely to have better health in their 70s whilst for women a long-term part-time arrangement seems to reap the most health benefits.

In short, it seems there may be considerable health benefits to part-time work but in ways that play out slightly differently for men and women. It should provoke interesting discussions among employers, unions, policy makers in the areas of employment and health and, of course workers themselves as they think about the sort of retirement they want and the options they have (or don’t have) when it comes to flexible working.

Given that less than 10 per cent of men and less than 5 per cent of women in our study followed these ‘optimum’ pathways for better health in their 70s, it’s an area that could serve as a real focus in the coming months, preferably before the pension reforms outlined earlier come into force.

Later-life employment trajectories and health is research by Peggy McDonough, Diana Worts, Laurie M. Corna, Anne McMunn, and Amanda Sacker and is published in the journal, Advances in Life Course Research.