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

TY - JOUR

T1 - Occupational and educational inequalities in exit from employment at older ages

T2 - evidence from seven prospective cohorts

AU - Carr, Ewan

AU - Fleischmann, Maria

AU - Goldberg, Marcel

AU - Kuh, Diana

AU - Murray, Emily T

AU - Stafford, Mai

AU - Stansfeld, Stephen

AU - Vahtera, Jussi

AU - Xue, Baowen

AU - Zaninotto, Paola

AU - Zins, Marie

AU - Head, Jenny

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2018/5

Y1 - 2018/5

N2 - OBJECTIVES: Past 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.METHODS: Prospective 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.RESULTS: There 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.CONCLUSIONS: Workers 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.

AB - OBJECTIVES: Past 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.METHODS: Prospective 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.RESULTS: There 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.CONCLUSIONS: Workers 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.

U2 - 10.1136/oemed-2017-104619

DO - 10.1136/oemed-2017-104619

M3 - Article

C2 - 29530976

SN - 1470-7926

VL - 75

SP - 369

EP - 377

JO - Occupational & Environmental Medicine

JF - Occupational & Environmental Medicine

IS - 5

ER -