Occupational and educational inequalities in exit from employment at older ages: evidence from seven prospective cohorts

Occupational and Environmental Medicine - Tập 75 Số 5 - Trang 369-377 - 2018
Ewan Carr1, Maria Fleischmann2, Marcel Goldberg3,3,4, Diana Kuh5, Emily Murray2, Mai Stafford5, Stephen Stansfeld6, Jussi Vahtera7, Baowen Xue2, Paola Zaninotto2, Marie Zins8,3,4, Jenny Head2
1Department of Biostatistics and Health Informatics Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
2Department of Epidemiology and Public Health, University College London, London, UK
3INSERM, Population-based Epidemiologic Cohorts Unit-UMS 011, Villejuif, France
4Paris Descartes University, Paris, France
5MRC Unit for Lifelong Health and Ageing, University College London, London, UK
6Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
7Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
8Inserm UMR 1168, VIMA, Villejuif, France

Tóm tắt

ObjectivesPast studies have identified socioeconomic inequalities in the timing and route of labour market exit at older ages. However, few studies have compared these trends cross-nationally and existing evidence focuses on specific institutional outcomes (such as disability pension and sickness absence) in Nordic countries. We examined differences by education level and occupational grade in the risks of work exit and health-related work exit.MethodsProspective longitudinal data were drawn from seven studies (n=99 164). Participants were in paid work at least once around age 50. Labour market exit was derived based on reductions in working hours, changes in self-reported employment status or from administrative records. Health-related exit was ascertained by receipt of health-related benefit or pension or from the reported reason for stopping work. Cox regression models were estimated for each study, adjusted for baseline self-rated health and birth cohort.ResultsThere were 50 003 work exits during follow-up, of which an average of 14% (range 2–32%) were health related. Low level education and low occupational grade were associated with increased risks of health-related exit in most studies. Low level education and occupational grade were also associated with an increased risk of any exit from work, although with less consistency across studies.ConclusionsWorkers with low socioeconomic position have an increased risk of health-related exit from employment. Policies that extend working life may disadvantage such workers disproportionally, especially where institutional support for those exiting due to poor health is minimal.

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Occupational and Environmental Medicine

Tập 75 Số 5

369-377

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