TY - JOUR
T1 - Multimorbidity and the Transition Out of Full-Time Paid Employment
T2 - A Longitudinal Analysis of the Health and Retirement Study
AU - van Zon, Sander K R
AU - Reijneveld, Sijmen A
AU - Galaurchi, Anne
AU - Mendes de Leon, Carlos F
AU - Almansa, Josué
AU - Bültmann, Ute
N1 - © The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: [email protected].
PY - 2020/3
Y1 - 2020/3
N2 - Objectives This study aims to examine whether older workers aged 50-64 years with multimorbidity are at increased risk to transition from full-time paid employment to part-time employment, partial retirement, unemployment, disability, economic inactivity, full retirement or die than workers without a chronic health condition and workers with one chronic health condition, and whether socioeconomic position (SEP) modifies these transitions.Method Using data from the Health and Retirement Study (1992-2014; n = 10,719), sub-distribution hazard ratios with 95% confidence intervals were calculated with a time-varying Fine and Gray competing-risks survival regression model to examine exit from full-time paid employment. We investigated the modifying effect of SEP by examining its interaction with multimorbidity.Results Workers with multimorbidity had a higher risk of transitioning to partial retirement (1.45; 1.22, 1.72), disability (1.84; 1.21, 2.78) and full retirement (1.63; 1.47, 1.81), and they had a higher mortality risk (2.58; 1.71, 3.88) than workers without chronic disorders. Compared to workers with one chronic health condition, workers with multimorbidity had an increased risk for partial (1.19; 1.02, 1.40) and full retirement (1.29; 1.17, 1.42), and mortality (1.49; 1.09, 2.04). Only SEP measured as educational level modified the relationship between multimorbidity and mortality.Discussion Workers with multimorbidity seem more prone to leave full-time paid employment than workers without or with one a chronic health condition. Personalized work accommodations may be necessary to help workers with multimorbidity prolong their working life.
AB - Objectives This study aims to examine whether older workers aged 50-64 years with multimorbidity are at increased risk to transition from full-time paid employment to part-time employment, partial retirement, unemployment, disability, economic inactivity, full retirement or die than workers without a chronic health condition and workers with one chronic health condition, and whether socioeconomic position (SEP) modifies these transitions.Method Using data from the Health and Retirement Study (1992-2014; n = 10,719), sub-distribution hazard ratios with 95% confidence intervals were calculated with a time-varying Fine and Gray competing-risks survival regression model to examine exit from full-time paid employment. We investigated the modifying effect of SEP by examining its interaction with multimorbidity.Results Workers with multimorbidity had a higher risk of transitioning to partial retirement (1.45; 1.22, 1.72), disability (1.84; 1.21, 2.78) and full retirement (1.63; 1.47, 1.81), and they had a higher mortality risk (2.58; 1.71, 3.88) than workers without chronic disorders. Compared to workers with one chronic health condition, workers with multimorbidity had an increased risk for partial (1.19; 1.02, 1.40) and full retirement (1.29; 1.17, 1.42), and mortality (1.49; 1.09, 2.04). Only SEP measured as educational level modified the relationship between multimorbidity and mortality.Discussion Workers with multimorbidity seem more prone to leave full-time paid employment than workers without or with one a chronic health condition. Personalized work accommodations may be necessary to help workers with multimorbidity prolong their working life.
KW - Chronic health condition
KW - Labor market participation
KW - Socioeconomic position
KW - Transition
KW - SOCIOECONOMIC-STATUS
KW - FOLLOW-UP
KW - OLDER WORKERS
KW - POOR HEALTH
KW - DISEASE
KW - LIFE
KW - EXIT
KW - DETERMINANTS
KW - INEQUALITIES
KW - POPULATION
U2 - 10.1093/geronb/gbz061
DO - 10.1093/geronb/gbz061
M3 - Article
C2 - 31083712
SN - 1079-5014
VL - 75
SP - 705
EP - 715
JO - The Journals of Gerontology. Series B: Psychological Sciences and Social Sciences
JF - The Journals of Gerontology. Series B: Psychological Sciences and Social Sciences
IS - 3
ER -