The GAZEL study, published Online First (www.thelancet.com) and in an upcoming edition of The Lancet, shows that ill-health, in terms of perceived health problems, is improved by retirement for all groups of workers except those with ideal working conditions. Thus to encourage older workers to remain in the workforce, working conditions must be made much more ideal for them than is currently the case. The Article is written by Dr Hugo Westerlund, Stress Research Institute, Stockholm University, Sweden, and University College London, UK, and colleagues.
The authors examined self-rated health in 14,714 employees (11 581 [79%] men) from the French national gas and electricity company, the GAZEL cohort, for up to 7 years before and 7 years after retirement, with yearly measurements from 1989 to 2007. They found that overall, suboptimum health increased with age. However, between the year before retirement and the year after, the estimated prevalence of suboptimum health fell from 19% to 14% , corresponding to a gain in health of 8—10 years. Put another way, in terms of the risk of suboptimal health, people suddenly got 8—10 years younger when they retired. This retirement-related improvement was found in both men and women, and across occupational grades. Furthermore, it was maintained throughout the 7 years after retirement. A poor work environment and health complaints before retirement were associated with a steeper yearly increase in the prevalence of suboptimum health while still in work, and a greater retirement-related improvement; however, people with a combination of high occupational grade, low demands, and high satisfaction at work showed no such retirement-related improvement. The authors note that this 'ideal' combination of circumstances only applied to around 2% of workers.
The authors say their work suggest that work puts an extra burden on health when it is highly demanding and not satisfying, but that the effects of this burden are reversible. The results also show that marital status did not affect the association between retirement and suboptimum health, potentially indicating that the retirement-related improvement was more related to work than to private life.
The data in this study are from employees in a company operating throughout France, both in rural and urban areas, comprising a wide range of occupations. However, compared with many employees worldwide, the participants retired early (from age 55 years) and benefited from good social security (receiving 80% of their former salary in pension). However, the substantial improvements shown by most employees suggests that the observed results could be fairly generalisable to other settings with generous social security after retirement and to a large proportion of employees in developed countries.
The authors say: "Our findings should cause concern for policy makers attempting to convince workers to stay longer in the workforce. Older workers who have deteriorating perceived health, and who might additionally be aware that many of their slightly older friends and former colleagues enjoy excellent health since they retired, might feel more motivated to retire early than to continue working beyond statutory retirement age."
They conclude: "If our findings apply in settings in which social security is less comprehensive than for participants in the GAZEL cohort study, financial incentive might not be enough—and not the most ethical way—to counteract the drift towards an earlier retirement age. Arguably the best option is to redesign working life for older workers to make it healthier and more satisfying than at present, and thus, hopefully, achieve improved occupational health and quality of life, increased productivity, and a larger proportion of the population in work."
In an accompanying Comment, Dr Johannes Siegrist and Dr Morten Wahrendorf, University of Düsseldorf, Germany, say: "The policy implications of Westerlund and colleagues' study are fairly convincing. If poor quality of work reduces health and wellbeing of aged workers and reduces the participation of this age-group in the labour force, efforts need to be directed towards improving healthy work at the level of single organisations and companies, and at the level of national labour and social policies."
Dr Hugo Westerlund, Stress Research Institute, Stockholm University, Sweden, and University College London, UK. T) +46-(0) 8-5537 8926 / +46-(0)76-814 1011E) hugo.westerlund@stress.su.se
Alternative contact: Sofia Lagergren, Press Office, Stockholm University, Sweden T) +46-(0)8-5537 8940 E) sofia.lagergren@stressforskning.su.se
Dr Johannes Siegrist, University of Dusseldorf, Germany. T) +49-211-8114360 E) siegrist@uni-duesseldorf.de
For full Article and Comment, see: http://press.thelancet.com/retirement.pdf
Notes to editors:
Dr Westerlund is currently in Puerto Rico (but is contactable there). Below is a list of alternative author contacts in case he cannot be reached.
Jussi Vahtera: jussi.vahtera@ttl.fi, +358405929990; Mika Kivimäki: mika.kivimaki@helsinki.fi, +358 40 730 8879; Archana Singh-Manoux: Archana.Singh-Manoux@inserm.fr, +33-(0)1-7774 7410; Maria Melchior: Maria.Melchior@inserm.fr, +33-(0)1-7774 7427; Jane E. Ferrie: jane@public-health.ucl.ac.uk, +44 (0)207 679 5634; Jaana Pentti: Jaana.Pentti@ttl.fi; Markus Jokela: markus.jokela@helsinki.fi, +358-9-19129483; Constanze Leineweber: constanze.leineweber@stressforskning.su.se, +46-(0)8-5537 8937; Marcel Goldberg: Marcel.Goldberg@inserm.fr, +33-(0)1-7774 7426 or +33-(0)6-8717 2997; Marie Zins: Marie.Zins@inserm.fr, +33-(0)1-7774 7428
Journal
The Lancet