’Active ageing’ and health: an exploration of longitudinal data for four European countries

Student thesis: Doctoral ThesisDoctor of Philosophy


WHO has promoted the idea of ‘Active Ageing’ as a strategy for promoting health and well-being among older people. Ageing well can be achieved by keeping active and involved in a broader range of activities than those normally associated with productivity. In this research three domains of ‘engagement’ were considered: paid work, formal involvement (i.e. activities such as voluntary work, attendance at training courses and participation in political organisations) and informal involvement (i.e. activities such as providing care and help to family, and looking after grandchildren). Using the first two waves of European and English Studies of Ageing (ELSA and SHARE), this thesis investigated both the cross-sectional association between socio-economic, demographic and health-related variables and engagement at baseline, and the longitudinal association between engagement at baseline and self-rated health (SRH) and depressive symptoms at follow-up (controlling for baseline measures of health). Cohort participants were aged 50-69 in Denmark, France, Italy and England, selected to represent different welfare regimes.
Cross-sectional findings showed that levels of engagement in paid work and formal activities varied across countries, whereas socio-economic, demographic and health-related characteristics were similarly associated with engagement in all countries under study. This suggested that country-specific factors, such as retirement policies, might play an important role in determining older people’s level of engagement in paid work. Cross-sectional results also suggested that work and formal engagement were associated with good health, whereas –among certain subpopulations –informal activities were associated with bad health. Longitudinal analyses showed that, in all countries, only respondents in paid work at baseline were more likely to increase their SRH and less likely to become depressed than those ‘inactive’. Formal and informal engagement were not significantly associated with health at follow-up. Longitudinal results and associations found, however, might have been biased by the high rates of attrition, as multiple imputations techniques and sensitivity analyses suggested.
The current research study confirms that engagement in work is an important pathway to health in late life. More attention, however, should be paid to people’s working lives, the quality of the work and the work conditions.
Date of Award2012
Original languageEnglish
Awarding Institution
  • LSHTM London School of Hygiene and Tropical Medicine
SupervisorEmily Grundy (Supervisor) & Anne Jamieson (Supervisor)


  • Active Ageing
  • ELSA
  • Europe
  • Longitudinal study
  • Attrition
  • Data Quality

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