Determinants of healthy ageing in work and retirement: a cross-national longitudinal study based on the IDEAR network

Lead Research Organisation: University College London
Department Name: Epidemiology and Public Health

Abstract

Retirement is a major turning point in life, when financial and social circumstances may change substantially. These changes may have a large impact on the health of older people. In recent years, the transition from working life to post-working life has become much less standardised than it was in the past. The effects of retirement are likely to be different depending on when and how people retire, as well as how they are able to adapt to life in retirement. Additionally, the effects of retirement may be influenced both by working conditions during the last years before retirement as well as by the social and socioeconomic conditions in retirement - including factors such as income from pensions, home ownership, as well as family structure and social networks outside of work. Health-related behaviours, such as exercise, diet, and sleeping patterns, are also likely to be important factors influencing health after retirement. We propose to investigate how all these factors in later working life, during the retirement transition, and in early retirement influence for how long older individuals are able to live actively and healthily. This will be done using well-established large studies on ageing and registry data from five European countries representing three different welfare regimes and spanning up to several decades of the middle years in work, retirement, early old age and the beginning of old-old age. The key questions that this proposed research seeks to address are:

What impact does retirement and other reasons for leaving employment have on the health and health behaviours of older people?

Do different patterns of retirement, such as prolonged working life versus early retirement, have different effects on the health and health behaviours of older people?

What are the processes during working life and the retirement transition that might contribute to poor health in later life?

Do these relationships between retirement patterns and health differ in different European countries?

Planned Impact

We will publicise our research findings by issuing press releases when papers are published to maximise media coverage.

We anticipate that the proposed research will be of interest to policy makers, including Department of Work and Pensions, Department of Health, and Health and Safety Executive. We will arrange at least one policy seminar in the second or third year of the project to inform policymakers of our key findings. This will follow the successful format used for the symposium jointly organised by the ESRC funded research seminar series on sickness absence (SARC) research group and the Government Office for the English Regions (GOER).

In addition, we will feed into relevant calls or respond to requests for information. We already have contact with relevant policy makers and organisations including Dame Carol Black, National Director for Health and Work and the UK Health and Safety Executive.

Publications

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Zaninotto P (2013) Relationship between wealth and age trajectories of walking speed among older adults: evidence from the English Longitudinal Study of Ageing. in The journals of gerontology. Series A, Biological sciences and medical sciences

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Sabia S (2014) Change in fast walking speed preceding death: results from a prospective longitudinal cohort study. in The journals of gerontology. Series A, Biological sciences and medical sciences

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Liao J (2014) Negative aspects of close relationships as risk factors for cognitive aging. in American journal of epidemiology

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Stenholm S (2015) Comorbidity and functional trajectories from midlife to old age: the Health and Retirement Study. in The journals of gerontology. Series A, Biological sciences and medical sciences

 
Description The Integrated Datasets in Europe for Ageing Research (IDEAR) network brought together occupational cohort and ageing studies to investigate how determinants in later working life, during the retirement transition, and in early retirement influence for how long older individuals are able to live healthily. Selected key findings are highlighted below.

Using prospective data drawn from longitudinal studies in England, Finland, France and Sweden , we estimated differences in two measures of health expectancy: (i) expected years spent in good self-rated health (healthy life expectancy) and (ii) expected years of life without major chronic health conditions including heart disease, stroke, diabetes, chronic lung disease and cancer (chronic disease- free life expectancy). Multistate life table models were used to estimate healthy life expectancy and chronic disease-free life expectancy from ages 50 to 75 by occupational position, health behaviours, sleep disturbances, working conditions and sex.
In all four cohorts, we found inequalities in healthy life expectancy between ages 50 to 75 according to occupational position such that men and women in the higher occupational positions had higher healthy life expectancy compared to those in low occupational positions. Similarly, there were occupational differences in expected years of life without chronic disease.

Smoking status, physical inactivity and obesity (body mass index = 30 kg/m2), all potentially modifiable risk factors, were examined separately and in combination. In all four countries, individual and co-occurring behavior-related risk factors were strongly associated with more years spent with ill health and more years spent with chronic diseases. When BMI was categorized into five groups from underweight (< 18.5 kg/m2) to obese II (= 35 kg/m2), proportion of life spent in sub-optimal health or with chronic diseases progressively decreased with increasing body mass index.

Poor psychosocial working conditions potentially limit quality of life and the possibilities for individuals to remain in paid employment because of poor health. However, no studies so far have investigated how psychosocial working conditions might impact on how long older workers can expect to stay healthy. We found that job strain (high job demands combined with low control) was consistently related to shorter healthy life expectancy in all cohorts.

A total of 20 papers have been published arising from the work of this network. The IDEAR network was also involved in an MRC/ESRC funded Extending Working Lives research consortium and contributes to other newly funded cross-national research consortia.

Several new researchers from the participating countries joined the IDEAR network during the project resulting in increased research capability in: cross-national research, harmonisation of measures across cohorts, and application of multistate model methodology for estimating health expectancies from longitudinal data.
Exploitation Route Our findings provide new information on the extent of variations between groups in the number of years that people can expect to spend in good health and the number of years spent without major chronic health conditions. These findings are relevant to the policy of many European governments to increase the length of working lives. We provided evidence to the independent review of UK state pension age beyond 2028 that made recommendations in 2017. Our findings have the potential to inform policies aimed at reducing inequalities in healthy life expectancy.
Sectors Healthcare,Government, Democracy and Justice

URL http://www.idear-net.net/
 
Description We have disseminated findings from our project at several events attended by government officials, public and voluntary sector representatives. Some of our research findings were included as a chapter in the Wave 7 report from the English Longitudinal Study of Ageing and were presented at the launch of the report (October 2016) . This led to commentary on our results in blog posts including from NATCEN ("We are living longer but will we all have the same chance to enjoy it"). Our results showing consistent socioeconomic inequalities in healthy life expectancy and disability-free life expectancy are highly relevant to the current debate on extending working lives and raising State Pension Age. We participated in a stakeholder event in 2016 to feed into the independent review of State Pension Age. We have been invited by the Department for Work and Pensions analysis team to provide further input into the independent review of State Pension Age in relation to variations in healthy life expectancy among older people. Further research papers from our project are due to be published in 2017. The nature of our research means that we would not expect impact to materialise immediately and we anticipate that our project will continue to generate impact in the coming years. To help achieve impact, we are preparing lay summaries and briefing notes to disseminate the key findings from our research. Additionally, we are planning further policy events in the UK and Europe. Our findings and events are publicised through our project website www.idear-net.net and our twitter account @IDEARNetwork.
First Year Of Impact 2016
Sector Healthcare,Government, Democracy and Justice
Impact Types Societal,Policy & public services

 
Description Cridland review of State Pension age 2017
Geographic Reach National 
Policy Influence Type Gave evidence to a government review
URL https://www.gov.uk/government/publications/state-pension-age-independent-review-final-report
 
Description Training in Modelling drop-out in ageing cohorts
Geographic Reach Europe 
Policy Influence Type Influenced training of practitioners or researchers
Impact Advanced training in quantitative methods for doctoral and postdoctoral researchers.
URL http://kiwas.ki.se/katalog/katalog/kurs/1737
 
Description Travel funds
Amount £10,290 (GBP)
Organisation Karolinska Institute 
Sector Academic/University
Country Sweden
Start 01/2013 
 
Description IDEAR network 
Organisation Finnish Institute of Occupational Health (FIOH)
Country Finland 
Sector Public 
PI Contribution The Integrated Datasets in Europe for Ageing Research (IDEAR) network brings together leading occupational cohort and ageing studies from five European countries to explore the impact of working conditions on health and well-being in later life. Our team contributes analyses of UK datasets to the research consortium and contributions to writing manuscripts.
Collaborator Contribution The partners provide data for pooled analyses and co-author papers.
Impact This is a multidisciplinary collaboration in epidemiology, public health, statistics and sociology.
Start Year 2013
 
Description IDEAR network 
Organisation Karolinska Institute
Country Sweden 
Sector Academic/University 
PI Contribution The Integrated Datasets in Europe for Ageing Research (IDEAR) network brings together leading occupational cohort and ageing studies from five European countries to explore the impact of working conditions on health and well-being in later life. Our team contributes analyses of UK datasets to the research consortium and contributions to writing manuscripts.
Collaborator Contribution The partners provide data for pooled analyses and co-author papers.
Impact This is a multidisciplinary collaboration in epidemiology, public health, statistics and sociology.
Start Year 2013
 
Description IDEAR network 
Organisation National Center for Scientific Research (Centre National de la Recherche Scientifique CNRS)
Department U1018 INSERM Center for Research in Epidemiology and Population Health
Country France 
Sector Public 
PI Contribution The Integrated Datasets in Europe for Ageing Research (IDEAR) network brings together leading occupational cohort and ageing studies from five European countries to explore the impact of working conditions on health and well-being in later life. Our team contributes analyses of UK datasets to the research consortium and contributions to writing manuscripts.
Collaborator Contribution The partners provide data for pooled analyses and co-author papers.
Impact This is a multidisciplinary collaboration in epidemiology, public health, statistics and sociology.
Start Year 2013
 
Description IDEAR network 
Organisation Stockholm University
Country Sweden 
Sector Academic/University 
PI Contribution The Integrated Datasets in Europe for Ageing Research (IDEAR) network brings together leading occupational cohort and ageing studies from five European countries to explore the impact of working conditions on health and well-being in later life. Our team contributes analyses of UK datasets to the research consortium and contributions to writing manuscripts.
Collaborator Contribution The partners provide data for pooled analyses and co-author papers.
Impact This is a multidisciplinary collaboration in epidemiology, public health, statistics and sociology.
Start Year 2013
 
Description IDEAR network 
Organisation Swansea University
Country United Kingdom 
Sector Academic/University 
PI Contribution The Integrated Datasets in Europe for Ageing Research (IDEAR) network brings together leading occupational cohort and ageing studies from five European countries to explore the impact of working conditions on health and well-being in later life. Our team contributes analyses of UK datasets to the research consortium and contributions to writing manuscripts.
Collaborator Contribution The partners provide data for pooled analyses and co-author papers.
Impact This is a multidisciplinary collaboration in epidemiology, public health, statistics and sociology.
Start Year 2013
 
Description IDEAR network 
Organisation University of Copenhagen
Country Denmark 
Sector Academic/University 
PI Contribution The Integrated Datasets in Europe for Ageing Research (IDEAR) network brings together leading occupational cohort and ageing studies from five European countries to explore the impact of working conditions on health and well-being in later life. Our team contributes analyses of UK datasets to the research consortium and contributions to writing manuscripts.
Collaborator Contribution The partners provide data for pooled analyses and co-author papers.
Impact This is a multidisciplinary collaboration in epidemiology, public health, statistics and sociology.
Start Year 2013
 
Description IDEAR network 
Organisation University of Turku
Country Finland 
Sector Academic/University 
PI Contribution The Integrated Datasets in Europe for Ageing Research (IDEAR) network brings together leading occupational cohort and ageing studies from five European countries to explore the impact of working conditions on health and well-being in later life. Our team contributes analyses of UK datasets to the research consortium and contributions to writing manuscripts.
Collaborator Contribution The partners provide data for pooled analyses and co-author papers.
Impact This is a multidisciplinary collaboration in epidemiology, public health, statistics and sociology.
Start Year 2013
 
Description Cross national comparisons of health in later life_Korea(Martin Hyde) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact A high level of interest generated.


Disseminated research results to scientific community.
Year(s) Of Engagement Activity 2013
 
Description DWP seminar 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Presentation and discussion of our research findings on inequalities in healthy life expectancy and working life expectancy to Department of Work and Pensions (DWP) Strategy Ageing Society and State Pensions team. Discussion of future research plans and what would be useful for DWP
Year(s) Of Engagement Activity 2017
 
Description ERA-AGE conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation of our findings to the ERA AGE conference.
Year(s) Of Engagement Activity 2015
URL http://era-age.group.shef.ac.uk/the-era-age-conference-2015.html
 
Description Healthandwellbeing@work conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Invited speaker on determinants of Healthy Life Expectancy and Extending Working Lives, National Policy and Initiatives programme stream, Health and Wellbeing at Work 2015. This led to increased involvement of non-academic stakeholders in our project and requests for further information on findings from our project.
Year(s) Of Engagement Activity 2015
URL http://healthwellbeingatwork.co.uk/
 
Description IDEAR Paris 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Gave talk about aims of the renEWL consortium.

Increased research collaboration.
Year(s) Of Engagement Activity 2014
 
Description ILC-UK panel on Working Longer in an Ageing Society 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation keynote/invited speaker
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Attracted great interest from scientists and policy makers.


Several people emailed me after the talk to ask to be kept informed of findings from our project.
Year(s) Of Engagement Activity 2013
URL http://www.ilcuk.org.uk/index.php/events/working_longer_in_an_ageing_society
 
Description JCRA AHA Programme Meeting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Meeting to share findings from the JCRA ERA AGE2 funded projects which led to networking and plans for future collaborations.
Year(s) Of Engagement Activity 2015
URL http://era-age.group.shef.ac.uk/
 
Description PHE academic network workshop on Work, Health and Wellbeing (Jenny Head) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation keynote/invited speaker
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Gave talk on Predictors of working beyond the age of 50:the renEWL consortium. This generated considerable interest in our research consortium from academics and public health practictioners.


Disseminated research results to scientific community and others. Increased collaboration and contact with practitioners in the area of work and health.
Year(s) Of Engagement Activity 2014
 
Description Presentation at GAZEL event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Study participants or study members
Results and Impact Presentation of our main findings at CONSTANCES/GAZEL workshop in Paris
Year(s) Of Engagement Activity 2016
 
Description Public Health England funded network on Work, Health and Wellbeing 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation of findings on working conditions as predictors of extended working lives.
Year(s) Of Engagement Activity 2014
URL http://www.ihs.manchester.ac.uk/ResearchNetworks/healthwork/WHWB101114/
 
Description Reconnecting the labour market process and the ageing process (Martin Hyde). 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Interest expressed in talk.

A high level of interest generated.
Year(s) Of Engagement Activity 2013