Gaining weight through retirement? Results from the SHARE survey

Does Retirement and Work Stoppage Impact Body Weight and Waist Circumference Changes in Middle- and Older-Aged Women and Men? Results From the Canadian Longitudinal Study on Aging

This study aimed to examine the impact of employment transitions (ETs) on anthropometric changes among middle-aged and older workers (ages 45y+). Using two waves of data from the Canadian Longitudinal Study on Aging, we analyzed the impact of ETs (stayed working, entered retirement, and stopped working) on change in body weight and waist circumference (WC) on continuous scales as well as categories (≥5% cut-off). Analyses were sex/gender-stratified. Women did not show significant weight or WC change that differed across ETs, but estimated directions suggested those who stopped working were more likely to have ≥5% change in weight. Estimated directions of continuous outcomes for women who stopped working relative to continued workers showed less weight gain and more WC gain. Men who retired gained less weight and had smaller WC gain compared to reference. The findings imply that the short-run impact of exiting the labor force may not exacerbate weight gain.

Effects of retirement on inpatient healthcare utilisation: an observational study in China

OBJECTIVE

Previous studies have presented mixed evidence on retirement and inpatient healthcare utilisation. We aimed to examine the causal effect of retirement on inpatient healthcare utilisation in China and explore the heterogenous effects of sex, disease types and ways of hospital admission.

DESIGN

This was a retrospective observational study from the electronic medical record at 376 tertiary hospitals in China between 2013 and 2018.

SETTING

Nationwide data from China.

PARTICIPANTS

We included the male sample aged between 50 and 70, and the female sample aged between 40 and 60 and with basic medical insurance system or public medical insurance. Observations with total expenditures per visit at the top or bottom 1% were excluded.

PRIMARY AND SECONDARY OUTCOME MEASURES

Inpatient expenditures per visit and inpatient days per visit.

METHODOLOGY

We examined the effects by a non-parametric fuzzy regression discontinuity design, exploiting the mandatory retirement age as a source of exogenous variation in retirement status.

RESULTS

Retirement reduced drug expenditures (β=-467.46, p<0.05) and inpatient days per visit (β=-0.99, p<0.05). The mitigation effect was concentrated on people admitted into hospital due to chronic diseases (β=-551.28, p<0.05 for drug expenditures; β=-1.08, p<0.05 for inpatient days per visit) and people admitted into hospital through outpatient services (β=-353.75, p<0.001 for drug expenditures). For males, retirement significantly reduced diagnostic tests expenditures (β=-302.38, p<0.05) and drug expenditures (β=-728.31, p<0.05). Retirement significantly reduced inpatient days per visit (β=-1.13, p<0.05) for females.

CONCLUSION

The empirical findings suggested that retirement may lead to a reduction in inpatient healthcare utilisation, which underlined the importance for policy-makers to consider the externalities of retirement policies on inpatient healthcare utilisation.

Examining the heterogeneity by employment status in dynamics between BMI and cognition: a longitudinal cohort study of the Korean aging population

PURPOSE

This study investigated the potential heterogeneity by employment status in the relationship between body mass index (BMI) trajectory and cognitive function among an aging population.

METHODS

We analyzed 2010-2018 cohort data from the Korean Longitudinal Study of Aging involving 4889 individuals aged over 45. We used statistical techniques of quadratic terms, interaction terms, time-invariant unobserved fixed effects, and time-lag effects to estimate the dynamic and interactive relationships among study variables.

RESULTS

The effect of BMI on cognitive function was heterogeneous based on employment status. For the nonemployed group, the impact of BMI on cognitive function showed an inverted U-shape with a turning point (BMI 25); a higher BMI (up to 25) was associated with higher cognitive function, but further increases beyond this threshold led to decreased cognitive function. For the employed group, however, the impact of BMI on cognitive function was nonsignificant. The nonlinear effect of BMI on cognitive function for the nonemployed group was robust across various subgroups and specifications.

CONCLUSIONS

The findings highlight the risk of obesity (BMI ≥ 25) on cognitive decline, particularly among nonemployed individuals. This illuminates the critical role of labor activity in regulating the impact of BMI on cognitive function among an aging population.

Effect of retirement on medical reimbursement expenses-evidence from China

BACKGROUND

Medical reimbursement in China is not for all diseases, and medical reimbursement expenses are not completely consistent with medical service demand, though the scope and proportion of medical reimbursement are gradually expanding. This study aimed to examine the effect of retirement on medical reimbursement expenses in urban China.

METHODS

The effect of retirement on medical reimbursement expenses were estimated by using fuzzy regression discontinuity based on data from the China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013, 2015, and 2018. Its group heterogeneity by educational backgrounds and marital status, and underlying mechanisms were also explored.

RESULTS

Retirement increased medical reimbursement expenses of outpatient significantly (P < 0.05).Low time cost and deteriorating health status after retirement were possible mechanisms in this association. Retirement increased the reimbursement expenses significantly among the older adults with more educational obtainment or being widowed/divorced.

CONCLUSION

The above findings indicated that there was a positive association between retirement and medical reimbursement expenses. The scope and proportion of medical reimbursement should be incorporated into retirement policy for improving medical service accessibility and rational healthcare utilization of retired population.

The effect of retirement on obesity in women: Evidence from China

Introduction

Retirement has been shown to impact individual health as an important life course, and we examined the impact of retirement on the prevalence of obesity in women based on a female perspective.

Methods

We use data from the five waves of the China Family Panel Study (CFPS) data from 2010 to 2018, with the body mass index (BMI) as the obesity measure. Fuzzy regression discontinuity design (FRDD) is used to overcome the endogeneity of retirement behavior and obesity.

Results

After retirement, the obesity rate among women increased 23.8%-27.4% (p < 0.05). The mechanism is that the activity consumption has not changed significantly, but the energy intake has increased significantly. In addition, we found that the effect of retirement on female obesity was strong heterogeneity.

Conclusions

The study found that retirement will increase the probability of obesity in women.

The Retirement-Health Puzzle: A Sigh of Relief at Retirement?

OBJECTIVES

While the health effects of retirement have been well studied, existing findings remain inconclusive, and the mechanisms underlying the linkage between retirement and health are unclear. Thus, this study aimed to evaluate the effects of retirement on health and its potential mediators.

METHODS

Using a national household survey conducted annually from 2004 to 2019 in Japan (the Japan Household Panel Survey), we evaluated the effects of retirement among Japanese men aged 50 or older on their health, in addition to other outcomes that could be attributed to health changes associated with retirement (i.e., health behaviors, psychological well-being, time use for unpaid activities, and leisure activities). As outcomes are not measured every year, we analyzed 5,794-10,682 person-year observations for 975-1,469 unique individuals. To address the potential endogeneity of retirement, we adopted an instrumental variable fixed-effects approach based on policy changes in eligibility ages for employee pensions.

RESULTS

We found that retirement improved psychological well-being, exercise habits, and time spent on unpaid work. The psychological benefits of retirement were no longer observed for longer durations after retirement, whereas healthy habits and unpaid activities continued. Moreover, health-related improvements after retirement occurred mostly in the higher-income group.

DISCUSSION

Enhancement in personal quality of life owing to increased leisure time and stress reduction from work in addition to lifestyle changes may be key to understanding the health benefits of retirement. Considering the mechanisms behind retirement-health relationships and potential heterogeneous effects is essential for healthy postretirement lives when increasing the retirement age.

Does retirement (really) increase informal caregiving? Quasi-experimental evidence from Australia

This paper analyzes the impact of retirement on informal care provision using nationally representative panel data from Australia. To establish causality, we exploit the gender and cohort specific eligibility age for the Australian Age Pension. We find no evidence of an impact of retirement (status or duration) on co-residential or extra-residential unpaid care provided by older individuals. The null effect of retirement on informal caregiving does not differ by the type of care recipient. Furthermore, we demonstrate that older people who postpone retirement reduce the amount of time they spend on other non-market activities to resolve the time conflict between unpaid care and extended employment. Our analysis indicates that the Australian Age Pension reform aimed at working career prolongation has not crowded out the supply of informal care.

Spillover effects of retirement: Does health vulnerability matter?

The current literature investigating the impact of retirement and the associated spousal spillover effects overlooks the unintended effects of retirement on spouses in vulnerable health, namely spouses with long-term health conditions (LTHCs). In this paper, we fill this gap in the literature and investigate the impact of an individual's retirement on their partner's health outcomes when their partner has LTHCs. Given the inherent identification challenges associated with entry into retirement, we use the pension-qualifying age in Australia as an instrument. Based on data from the Household Income and Labour Dynamics in Australia survey, we find that the husband's retirement has a positive impact on the wife's quality-adjusted life years (QALY) and other physical and mental health outcomes. We also identify redistribution of domestic workload as a key transmission mechanism of the spousal spillover effects. Women with LTHCs will see their QALY and health improve only if their husband devotes more time to domestic tasks after retirement.

Heterogeneous effects of retirement on the biomedical risk factors for cardiovascular and metabolic diseases: New evidence based on the physical examination database in Shanghai, China

Retirement has a heterogeneous impact depending on gender and occupation. This study aimed to analyze and evaluate the heterogeneity and potential mechanism of retirement on the biomedical risk factors for cardiovascular and metabolic diseases. Physical examination data from 2017 to 2020 were extracted from a hospital database in Shanghai. The fluctuation tendency of biomedical risk factor indicators for cardiovascular and metabolic diseases was evaluated by gender and occupation shortly after retirement using fuzzy regression discontinuity design and was analyzed for internal mechanism. Retirement had a significantly negative influence on body weight (β = -3.943), body mass index (β = -2.152), and diastolic blood pressure (β = -5.180) in women working in public institutions or state-owned enterprises, but a positive influence on their blood glucose level (β = 0.696). Retirement had a significantly positive effect on high-density lipoprotein in men (β = 0.138), particularly those employed in private enterprises (β = 0.339). The internal influencing mechanism of retirement showed that the health attention effect after retirement among women in government or public institutions on diastolic blood pressure reduction was better than that before retirement. The body weight, body mass index, and diastolic blood pressure of women in public institutions or state-owned enterprises were reduced at retirement; however, they were exposed to higher risks of elevated blood glucose level. Conversely, high-density lipoprotein level, which is protective against cardiovascular disease, was increased in men at retirement. Retirement has a heterogeneous effect on cardiovascular and metabolic health among people of different genders or occupational experiences. Retirees with low health awareness should be targeted for behavioral interventions and monitored conscientiously by health providers during retirement adaptation.

No "honeymoon phase": whose health benefits from retirement and when

Does retirement lead to a short, transitory health boost, followed by a stable longer-run effect? The short-run effect has been hypothesized to be a kind of honeymoon effect, that is followed by a longer-run effect that may be either positive or negative. We examine the time path of the health effect of retirement and study effect heterogeneities between individuals along several dimensions. Moreover, we study a broad range of health outcomes, all in order to come to an understanding of the effect patterns that lie behind the diverse findings reported in previous research. For identification we use a fixed effects instrumental variable approach in which the normal and early retirement age thresholds serve as instruments. Using data for 10 countries from the Survey of Health, Retirement and Ageing in Europe (SHARE), we find that retiring both at the normal and early retirement eligibility ages significantly improves all the health aspects we consider. Other than hypothesized, results do not show a honeymoon phase-like transitory health boost. Instead, especially blue-collar workers go through an adjustment period after retiring, in which their health worsens. Afterwards, health stabilizes and improves, so that retirement has a health preserving effect in the longer run. This beneficial health effect of retirement occurs across all occupational groups, across a range of health outcomes, and for both sexes, though there are a number of heterogeneities between groups regarding which health outcomes are particularly affected.

Association between the Intake of Different Protein Sources and Obesity Coexisting with Low Handgrip Strength in Persons near Retirement Age

Nutrition is important for preventing and treating sarcopenic obesity/SO, proteins play a fundamental role. This study aimed at (1) identifying the association between different protein sources, other factors, and obesity coexisting with low handgrip strength and (2) evaluating differences in protein intake between persons with coexistence of obesity with low handgrip strength, obesity alone, low handgrip strength alone and persons neither obese nor having low handgrip strength. This study is a secondary data analysis of SHARE-data among 5362 persons near retirement age. We used descriptive statistics, statistical tests and univariate and multiple logistic regression analyses. Prevalence of obesity coexisting with low handgrip strength was 4.8%. Participants with low handgrip strength had the significantly lowest intake of all protein groups, followed by participants with obesity and low handgrip strength (p < 0.001). Daily intake of meat/fish (0.56, CI 0.40−0.79), age (1.07, CI 1.03−1.11), two or more chronic diseases (2.22, CI 1.69−2.93), one or more limitations concerning instrumental activities of daily living (2.23, CI 1.60−3.11), and moderate activity more than once a week (0.44, CI 0.33−0.57) were significantly related factors regarding obesity coexisting with low handgrip strength. Findings suggest that a daily intake of meat/fish is associated with lower odds of suffering from obesity with low handgrip strength in retirement-aged persons. Further studies are needed for specific recommendations regarding different protein sources for obese persons with low muscle mass and/or strength.

Voluntary early retirement and mortality in patients with and without chronic diseases: a nationwide Danish Registry study

OBJECTIVE

This study explores how the choice of voluntary early retirement (VER) affects mortality in a population where VER is available 5 years before regular retirement age.

STUDY DESIGN

This retrospective cohort study uses a registry-based follow-up design with access to Nationwide Danish Registry Data.

METHODS

The study includes all Danish individuals who between 2000 and 2015 were part of an unemployment insurance fund and working at the time of their 60th (P60) or 62nd (P62) birthday. Those alive 1 year from their 60th or 62nd birthday were included in the mortality analysis. Individuals were registered as VER recipients if they chose the benefit within 1 year from P60 or P62. Three-year mortality likelihood following the first year from inclusion was explored for both cohorts separately. Multiple subgroups were explored in the mortality analysis, including individuals with chronic obstructive pulmonary disease (COPD), heart failure, and diabetes.

RESULTS

P60 included 627,278 individuals, and VER was chosen by 22.5%. P62 included 379,196 individuals, and VER was chosen by 33.4%. The likelihood of VER in the P60 was lower in healthy individuals (odds ratio [OR] 0.87, confidence interval [CI] 0.85-0.88) and higher in COPD (OR 1.15, CI 1.07-1.22) and heart failure patients (OR 1.15, CI 1.05-1.25). Three-year mortality was significantly higher in those choosing VER in P60 (OR 1.28, CI 1.22-1.34), which was also found for all health subgroups (healthy, OR 1.18, CI 1.07-1.30; COPD, OR 1.55, CI 1.16-2.07; heart failure, OR 1.42, CI 1.02-1.98; diabetes, OR 1.36, CI 1.12-1.65). The increased mortality risk was not found in the P62 cohort.

CONCLUSION

The choice of VER is more likely in patients with COPD and heart failure. VER in the P60 cohort is associated with an increased mortality likelihood, which was not found in the P62 cohort, which may be explained by health selection bias.

A systematic review of evidence on employment transitions and weight change by gender in ageing populations

Background

Becoming unemployed is associated with poorer health, including weight gain. Middle- and older-age adults are a growing segment of workforces globally, but they are also more vulnerable to changes to employment status, especially during economic shocks. Expected workforce exits over the next decade may exacerbate both the obesity epidemic and the economic burden of obesity. This review extends current knowledge on economic correlates of health to assess whether employment transitions impact body weight by sex/gender among middle-aged and older adults.

Methods

Eight bibliometric databases were searched between June and July 2021, supplemented by hand-searches, with no restriction on publication date or country. Longitudinal studies, or reviews, were eligible when examining body weight as a function of employment status change in adults ≥50 years. Data extraction and quality appraisal used predefined criteria; reported findings were analysed by narrative synthesis.

Results

We screened 6,001 unique abstracts and identified 12 articles that met inclusion criteria. All studies examined retirement; of which two also examined job-loss. Overall, studies showed that retirement led to weight gain or no difference in weight change compared to non-retirees; however, reported effects were not consistent for either women or men across studies or for both women and men within a study. Reported effects also differed by occupation: weight gain was more commonly observed among retirees from physical occupations but not among retirees from sedentary occupations. Few studies assessed the role of health behaviours; sleep was the least studied. Most studies were medium quality.

Conclusions

Existing studies do not provide a clear enough picture of how employment transitions affect body weight. Firm conclusions on the impact of employment transitions on weight cannot be made without further high-quality evidence that considers the role of gender, job-type, other health behaviours, and other transitions, like job-loss.

Understanding the effect of retirement on health behaviors in China: Causality, heterogeneity and time-varying effect

Retirement is an important turning point during the course of life, but few studies have examined the effects of retirement on a broad range of health behaviors in China. We use the longitudinal data of the China Health and Nutrition Survey (CHNS) from 2004 to 2015 to conduct empirical analysis. Fuzzy discontinuity regression was used to assess the association between retirement and health behaviors in the entire sample and subgroups based on gender and education. A time-varying effect model was used to measure the anticipatory effect, immediate effect and lag effect of retirement. We observed that the transition to retirement was associated with healthier lifestyle habits, such as reduced smoking and alcohol consumption and increased exercise motivation. However, the transition was associated with worse sedentary behavior. No significant statistical association was found between retirement and sleep duration. Men and those with higher education levels are more likely to experience the impact of retirement. The anticipatory effect suggests that as the statutory pension age is predictable, workers adjust their behaviors 4 and 5 years before retirement. The lagged effect indicates that it takes time to develop new habits; thus, retirees change their behaviors 2-3 years after retirement. The paper discusses possible reasons for our findings and proposes several policy implications from the perspectives of the government and society to facilitate the realization of healthy aging.

The impact of retirement on inpatient healthcare utilization in Guangzhou, China: a regression discontinuity analysis of 189,031 health insurance claims

Background

Previous studies suggest that retirement, a major life event, affects overall healthcare utilization. We examine, the effects of retirement on inpatient healthcare utilization, including effect heterogeneity by gender, disease category, and type of health service.

Methods

We used routine health insurance claims data (N = 87,087) spanning the period 2021 - September 2013 from the Urban Employee Basic Medical Insurance (UEBMI), a mandatory social health insurance for working and retired employees in urban China. We applied a non-parametric fuzzy regression discontinuity design using the statutory retirement age in urban China as an exogenous instrument to measure the causal effect of retirement on six measures of inpatient healthcare utilization.

Results

Retirement reduced total hospital costs (-84.71 Chinese Yuan (CNY), 95% confidence interval (CI) -172.03 – 2.61), shortened length of hospital stays (-44.59, 95% CI -70.50 – -18.68), and increased hospital readmissions (0.06, 95% CI 0.00 – 0.12) and primary hospital visits (0.06, 95% CI 0.02 – 0.09) among women. Retirement did not significantly change inpatient healthcare utilization among men. The retirement effects among women varied by disease category. Specifically, retirement substantially increased hospitalizations for non-communicable diseases (NCDs), yet had only modest or no effect on hospitalizations for communicable diseases or injuries. Retirement effects among women also varied by the type of services. For relatively inexpensive services, such as nonoperative treatment, there were surges in the extensive margin (hospital readmission). For relatively expensive and invasive services, such as surgeries, retirement reduced the intensive margin (out-of-pocket expenditures and length of stay).

Conclusions

Retirement decreases overall use of inpatient healthcare for women. The examination on the disease-related heterogeneous effects helps with the introduction and implementation of integrated healthcare delivery and appropriate incentive schemes to encourage better use of healthcare resources among older adults.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02664-2.

Self-Perception or Objective State: A Further Study of the Effects of Retirement on Health

Against the backdrop of an aging global population and the increasing pressure of medical care expenditures for seniors, this paper used a fuzzy regression discontinuity (FRD) model to explore the effects of retirement on the self-assessed health and objective physical and mental health of older people. Using survey data from the China Health and Retirement Longitudinal Study (CHARLS), our model addresses some relevant academic controversies. Our sample was comprised of male respondents from government agencies, enterprises, and public institutions. The research explored the impact of retirement on lifestyle habits and included an in-depth analysis of the mechanism through which retirement influences different aspects of health. The results show that: (1) Retirement does not have any significant impact on objective health, including depression and self-care ability, but it does cause a notable decline in subjective health assessment. (2) Retirement shortened the sleep time of respondents, which may account for lower scores on subjective health self-evaluations, but it did not lead to any noticeable improvement in habits which are harmful to health, such as smoking and drinking. (3) Marriage can help alleviate the problems of depression and smoking among older people, and education has a somewhat broader positive effect on their health and lifestyles; however, neither factor helps to improve the sleep problems of older people. Therefore, this paper recommends that efforts should be made to both optimize retirement policies and seek further ways to improve the health of the retired population.

Does retirement affect secondary preventive care use? Evidence from breast cancer screening

This paper examines the causal impact of retirement on preventive care use by focusing on breast cancer screening. It contributes to a better understanding of the puzzling results in the literature reporting mixed effects on health care consumption at retirement. We use five waves of data from the Eurobarometer surveys conducted between 1996 and 2006, covering 25 different European countries. We address the endogeneity of retirement by using age thresholds for pension eligibility as instrumental variables in a bivariate probit model. We find that retirement reduces mammography use and other secondary preventive care use. Our results suggest that health status, income, and knowledge on cancer prevention and treatment contribute little to our understanding of the effects of retirement. Instead, our evidence suggests important effect heterogeneity based on the generosity of the social health insurance system and organized screening programs.

Outcomes of bariatric surgery in elderly patients: a registry-based cohort study with 3-year follow-up

BACKGROUND

Elderly patients undergo bariatric surgery less frequently than younger patients. Short- and medium-term outcomes after bariatric surgery in the elderly population remain largely unknown. The objective of the present retrospective, registry-based cohort study was to compare short- and medium-term outcomes between patients <65 and ≥65 years undergoing bariatric surgery, hypothesizing similar outcomes between groups.

METHODS

In this retrospective, registry-based cohort study, the Ontario Bariatric Registry was used to compare data of patients <65 and ≥65 years who underwent Roux-en-Y gastric bypass and sleeve gastrectomy between January 2010 and August 2019 in all accredited bariatric centers of excellence in Ontario, Canada. Primary outcomes were overall postoperative complications. Secondary outcomes included early (<30 days) complications, readmissions, reoperations, mortality, weight loss and comorbidities improvement at 1 and 3 year after surgery.

RESULTS

Data of 22,981 patients <65 and 532 patients ≥65 years were analyzed. Overall postoperative complications were similar between patients <65 and ≥65 years (3388/22,981 [14.7%] vs. 73/532 [13.7%], p = 0.537). Early (<30 days) postoperative complications, readmissions, reoperations, and mortality rates were also similar between groups. Both groups had significant weight loss and comorbidities improvement at 1- and 3-year follow-up. Patients <65 years had superior weight loss (+3.5%, 95% CI: 1.6-5.4, p < 0.001) and higher rates of remission for diabetes mellitus (63.8% vs. 39.3%, p < 0.001), hypertension (37.9% vs. 14.5%, p < 0.001), dyslipidemia (28.2% vs. 9.5%, p < 0.001) and gastroesophageal reflux (65.1% vs. 24.0 %, p < 0.001) compared to patients ≥65 years at 3 year.

CONCLUSIONS

Patients <65 and ≥65 years had similar perioperative morbidity and mortality after bariatric surgery. Even though patients <65 years had overall better medium-term outcomes, bariatric surgery is safe and yields significant weight loss and comorbidities improvement in patients ≥65 years.

Does retirement reduce familiarity with Information and Communication Technology?

This paper analyses the effect of retirement on the familiarity with Information and Communication Technology (ICT) of older individuals. We argue that inability to cope with ICT might represent a threat for older individuals' social inclusion. To account for the potential endogeneity of retirement with respect to familiarity with ICT, we instrument retirement decision with the age-eligibility for early and statutory retirement pension schemes. Using data from the Survey of Health, Ageing and Retirement in Europe, we show that retirement reduces the computer literacy and the frequency of internet utilization for men and women. This finding is robust to the inclusion as control factors of health, cognition and social network indicators, which the literature has shown to be affected by retirement. Overall, the reduction in the familiarity with ICT after retirement tends to be stronger in the long-run.

The Relevance of Diet, Physical Activity, Exercise, and Persuasive Technology in the Prevention and Treatment of Sarcopenic Obesity in Older Adults

The aging population faces two conditions that threaten healthy aging: high fat mass (obesity) and low muscle mass and function (sarcopenia). The combination of both-referred to as sarcopenic obesity-synergistically increases the risk of adverse health outcomes. The two conditions often co-occur because they reinforce each other and share common etiologies, including poor nutrition and inactivity. All aging people are at risk of gaining weight and losing muscle mass and could benefit from improvements in physical activity, exercise and dietary intake. one specific window of opportunity is during the transient time of retirement, as older adults already need to restructure their daily activities. It is key to change lifestyle behavior in a sustainable manner, providing scientifically proven, personalized, and acceptable principles that can be integrated in daily life. Health technologies (e.g., applications) can provide promising tools to deliver personalized and appealing lifestyle interventions to a large group of people while keeping health care costs low. Several studies show that health technologies have a strong positive effect on physical activity, exercise and dietary intake. Specifically, health technology is increasingly applied to older people, although strong evidence for long term effects in changing lifestyle behavior is generally lacking. Concluding, technology could play an important role in the highly warranted prevention of sarcopenic obesity in older adults. Although health technology seems to be a promising tool to stimulate changes in physical activity, exercise and dietary intake, studies on long lasting effects and specifically targeted on older people around the time of retirement are warranted.

Impact of later retirement on mortality: Evidence from France

This paper investigates the impact of delaying retirement on mortality among the French population. We take advantage of the 1993 pension reform in the private sector to identify the causal effect of an increase in claiming age on mortality. We use administrative data which provide detailed information on career characteristics, dates of birth and death. Our results, precisely estimated, show that an exogenous increase of one year in the claiming age has no significant impact on the probability to die, measured between age 61 and 79, even when we allow for nonlinear effects of treatment intensity. To test the power of our sample to detect statistically significant effects for rare events like death, we compute minimum detectable effects (MDEs). Our MDE estimates suggest that, if an impact of later retirement on mortality would be detectable, it would remain very small in magnitude.

A Healthy Retirement Program for Thai government teachers: a quasi-experimental and comparison groups study

Purpose

The purpose of this study is to evaluate the Healthy Retirement Program's effectiveness toward skills improvement and evaluate changes in subjective health.

Design/methodology/approach

A quasi-experimental, pre and posttest of the comparison groups was conducted. Teachers who were going to retire within one year were recruited into the experimental (n = 47) and the comparison groups (n = 43). Questionnaires were administered at baseline, posttest and at the 6-months follow-up. An independent t-test and Mann–Whitney U test were applied to determine the differences in outcomes between groups.

Findings

The results revealed different effects regarding teachers' health status. In those who had no chronic disease, the experimental group had higher skills to understand health information at posttest and at follow-up (p = 0.036, 0.028). Skills to apply health information was also greater at follow-up (p = 0.042). Among those suffering from a chronic disease, skills to access and apply health information were significantly higher in the experimental group than that of the comparison at follow-up (p = 0.011, 0.046). Greater perceived health of the experimental group was also indicated (p = 0.032).

Originality/value

While the health conditions of teachers at the preretirement period are inconsistent, healthy lifestyle management after retirement is a crucial skill for retirement adjustment. Supporting teachers to be health literate should be included in the retirement planning program which emphasizes preretiree's ability to understand and take control of their health.

Financial health and obesity

We use individual-level panel data from the English Longitudinal Survey of Ageing over the period 2004-2013 to investigate the links between financial health and obesity. We find that having no debt (high savings) is associated with a 3.6 (1.6) percentage point lower probability of having a Body Mass Index in excess of 30. Our results are robust to using different estimation methods, to measuring financial health with a subjective indicator, and adiposity with waist circumference. A lower rate of time preference and lower stress levels may be mechanisms which help to explain the association between good financial health and obesity.

[Impact of retirement on health: A meta-analysis]

Un système de retraite financé par répartition requiert l’équilibre entre la population qui contribue aux prestations et celle qui en bénéficie. Or, dans la plupart des pays occidentaux, le nombre de personnes âgées (bénéficiaires) augmente plus vite que le nombre d’actifs (contributeurs). Cette constatation a incité les différents gouvernements à mettre en place des réformes visant à augmenter l’âge de départ à la retraite afin d’inverser cette tendance. L’étude des effets de ces réformes sur la santé présente un double intérêt du point de vue de la politique publique. En effet, la pénibilité ou les risques pris dans certaines professions peuvent être à l’origine de coûts en termes de santé, qui peuvent être accentués par un allongement de la durée de carrière. Il semble donc essentiel de mesurer les répercussions sociales de telles réformes et d’avoir une idée précise de leurs effets sur les inégalités de santé. Ces réformes allongeant la durée de vie travaillée pourraient également avoir un impact sur les dépenses de santé, avec le basculement des coûts de la branche retraite vers la branche maladie du système de sécurité sociale, ce qui en conséquence atténuerait les bénéfices attendus de ces réformes. Les études épidémiologiques révèlent l’existence d’une corrélation négative entre retraite et santé (être à la retraite est associé à une moins bonne santé). Pour autant, il est difficile d’en déduire que partir à la retraite détériore l’état de santé. En effet, certains individus restent plus longtemps en emploi, justement parce que leur état de santé le leur permet. Dans cette revue, nous présentons une analyse comparée des résultats obtenus dans la littérature, en nous focalisant sur l’effet causal de la retraite sur la santé, et non l’inverse (→). Nous distinguons ainsi trois éléments : le départ à la retraite, c’est-à-dire la transition entre l’emploi et la retraite ; l’allongement de l’âge de départ à la retraite ; et la réduction de l’âge de départ à la retraite. Nous examinerons ainsi les mécanismes pouvant expliquer le lien entre retraite et santé et détaillerons les outils permettant d’en identifier l’effet causal. Nous présenterons ensuite les résultats empiriques (ou observationnels) issus d’études examinant ce lien de causalité.

(→) Voir le Forum de T. Barnay, m/s n° 10, octobre 2016, page 889

Socioeconomic and behavioral determinants of cardiovascular diseases among older adults in Belgium and France: A longitudinal analysis from the SHARE study

Despite advances in the healthcare system, cardiovascular diseases (CVDs) are still an important public health problem with disparities in the burden within and between countries. Studies among the adult population documented that socioeconomic and environmental factors play a role in the incidence and progression of CVDs. However, evidence is scarce on the socioeconomic determinants and the interplay with behavioral risks among older adults. Therefore, we identified socioeconomic and behavioral determinants of CVDs among older adults. Our sample consisted of 14,322 people aged 50 years and above from Belgium and France who responded to the waves 4, 5, 6 and/or 7 of the Survey of Health Ageing and Retirement in Europe. The effect of determinants on the occurrence of CVD was examined using a Generalized Estimating Equation (GEE) approach for binary longitudinal data. The overall rate of heart attack was 8.3%, which is 7.6% in Belgium and 9.1% in France. Whereas, 2.6% and 2.3% in Belgium and France, respectively, had experienced stroke. In the multivariable GEE model, older age [AOR: 1.057, 95%CI: 1.055-1.060], living in large cities [AOR: 1.14, 95%CI: 1.07-1.18], and retirement [AOR: 1.21, 95%CI: 1.16-1.31] were associated with higher risk of CVD. Furthermore, higher level of education [AOR: 0.82, 95%CI: 0.79-0.90], upper wealth quantile [AOR: 0.82, 95%CI: 0.76-0.86] and having social support [AOR: 0.81, 95%CI: 0.77-0.84] significantly lowers the odds of having CVD. A higher hand grip strength was also significantly associated with lower risk of CVD [AOR: 0.987, 95%CI: 0.984-0.990]. This study demonstrated that older adults who do not have social support, live in big cities, belong to the lowest wealth quantile, and have a low level of education have a higher likelihood of CVD. Therefore, community-based interventions aimed at reducing cardiovascular risks need to give more emphasis to high-risk retired older adults with lower education, no social support and those who live in large cities.

The Impact of Retirement on Cardiovascular Disease and Its Risk Factors: A Systematic Review of Longitudinal Studies

Background and Objectives

People are now spending longer in retirement than ever before and retirement has been found to influence health. This study systematically reviewed the impact of retirement on cardiovascular disease (CVD) and its risk factors (metabolic risk factors, blood biomarkers, physical activity, smoking, drinking, and diet).

Research Design and Methods

Longitudinal studies published in Medline, Embase, Social Science Citation Index, PsycINFO, and Social Policy and Practice were searched. No language restrictions were applied if there was an English abstract. Eighty-two longitudinal studies were included after critical appraisals.

Results

Studies in the United States often found no significant effect of retirement on CVD, while studies in European countries, except France, showed a detrimental effect of retirement on CVD. Results from the United States and several European countries consistently show that retirement increase adiposity measures among those retired from physically demanding jobs. For diabetes and hypertension, five out of nine studies suggest no effect of retirement. Retirement has been repeatedly linked to increasing leisure-time physical activity but may reduce work- and transport-related physical activity in turn. Most studies showed that retirement either decreased smoking or had no effect on smoking. The evidence did not show a clear conclusion on drinking. Only a few studies have assessed the impact on diet and blood biomarkers.

Discussion and Implications

Effect of retirement varies according to the health outcomes studied and country of the study population. Policy concerning extending the retirement age needs to focus on ensuring they are suited to the individual.

The heterogeneous effect of retirement on informal care behavior

It is often argued that the increased labor market participation of seniors threatens family support provided to dependent elderly people. The purpose of this paper is to assess the causal effect of retirement on the frequency of care provided by individuals aged 55-69 years to their elderly parent. Using data from the Survey of Health, Aging and Retirement in Europe (SHARE), we estimate an endogenous switching model that allows the retirement effect to be heterogeneous with respect to observed and unobserved characteristics. To tackle the possible endogeneity of selection into retirement, we use the heterogeneity of retirement rules between and within European countries. On average, being retired does not significantly impact the probability of providing care but significantly increases the frequency of care conditional on being caregiver. The same pattern is observed regardless of the individual observed characteristics, even if the provision of informal care appears to be less sensitive to the retirement status when the child cannot rely on the other parent to provide care or when both parents are in poor health. These results suggest that pension system reforms should not affect the number of caregivers. Some adverse effects on the intensity of involvement among caregivers are nevertheless expected.

The effect of retirement on biomedical and behavioral risk factors for cardiovascular and metabolic disease

Retirement is a major life event potentially associated with changes in relevant risk factors for cardiovascular and metabolic conditions. This study analyzes the effect of retirement on behavioral and biomedical risk factors for chronic disease, together with subjective health parameters using Southern German epidemiological data. We used panel data from the KORA cohort study, consisting of 11,168 observations for individuals 45-80 years old. Outcomes included health behavior (alcohol, smoking, physical activity), biomedical risk factors (body-mass-index (BMI), waist-to-hip ratio (WHR), glycosylated hemoglobin (HbA1c), total cholesterol/HDL quotient, systolic/diastolic blood pressure), and subjective health (SF12 mental and physical scales, self-rated health). We applied a parametric regression discontinuity design based on age thresholds for pension eligibility. Robust results after p-value corrections for multiple testing showed an increase in BMI in early retirees (at the age of 60) [β = 1.11, corrected p-val. < 0.05] and an increase in CHO/HDL in regular retirees (age 65) [β = 0.47, corrected p-val. < 0.05]. Stratified analyses indicate that the increase in BMI might be driven by women and low educated individuals retiring early, despite increasing physical activity. The increase in CHO/HDL might be driven by men retiring regularly, alongside an increase in subjective physical health. Blood pressure also increased, but the effect differs by retirement timing and sex and is not always robust to sensitivity analysis checks. Our study indicates that retirement has an impact on different risk factors for chronic disease, depending on timing, sex and education. Regular male, early female, and low educated retirees should be further investigated as potential high-risk groups for worsening risk factors after retirement. Future research should investigate if and how these results are linked: in fact, especially in the last two groups, the increase in leisure time physical activity might not be enough to compensate for the loss of work-related physical activity, leading thus to an increase in BMI.

The Effect of Pre-Post Differences in Walking, Health, and Weight on Retirees' Long-Term Quality of Life

This research examined the effect of pre-post differences in walking duration, health, and weight on retirees' long-term quality of life (QoL). It used data from a 2018 randomized mail survey of 483 suburban New Jersey retirees. Ordinary least squares and three-stage least squares models were used. The analysis showed that changes in walking duration during the first 2 years of retirement are directly associated with health change, health change has an effect on long-term QoL, and weight variation of 10 lb or more has an effect on health change and long-term QoL. Although QoL peaks for the sample of retirees at around age 75, people whose average walking duration increased, health improved, and weight did not increase substantially after retirement continued to experience high QoL for a longer time. The results show that people can achieve high long-term QoL by choosing an active lifestyle when transitioning to retirement.

Self-employment, depression, and older individuals: A cross-country study

BACKGROUND

Self-employment has become an increasingly popular occupational choice, and there are substantial mental health and well-being benefits that can accrue for individuals who remain active and engaged later in life. In this study, we examine the association between reduced depression symptoms and self-employment in aging workers.

METHODS

Drawing from The Survey of Health, Ageing and Retirement in Europe (SHARE) data, our study examines a longitudinal sample of 35,717 individuals aged 50 years or older.

RESULTS

Our results indicate that self-employment is negatively associated with depression among aging workers. Additionally, we find that this relationship weakens as aging self-employed individuals grow older, and that gender moderates this relationship such that older female self-employed individuals report lower depression symptoms than their male counterparts.

LIMITATIONS

Our sample is limited to European workers aged 50 years and older, and as such might have limited generalizability to younger self-employed individuals from other geographic regions. Moreover, although we control for factors that could play a role in the association between depression symptoms and self-employment (e.g. quality of life, personality traits, etc.), additional research will be needed in order to determine the potential mediating and moderating roles such factors might have on this relationship.

CONCLUSIONS

The results we present demonstrate the important and nuanced nature between self-employment and depression symptoms in aging workers. These findings call to light the need to continue to foster and develop systems and programs that help to facilitate self-employment for individuals as they transition into older ages.

Retirement and Healthy Eating

This paper investigates the effect of retirement on healthy eating using data drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE). We estimate the causal effect of retiring from work on daily fruit or vegetable consumption by exploiting policy changes in eligibility rules for early and statutory retirement. Our results show that changes in eating behaviour upon retirement are gender-specific: retirement induces men to reduce healthy eating; it has no effect on women. We further show that, for men, retirement increases the probability of becoming obese.

Retirement Effect on Health Status and Health Behaviors in Urban China

This paper analyzes the causal impact of retirement in China on Body Mass Index (BMI) and weight, which are a good gauge of the risk for some diseases. Many middle income developing countries are aging very rapidly and may have to adjust the retirement age to have financially feasible government budgets. It is important to know and understand any plausible health consequences of raising the retirement age in developing countries, and which sub-populations within these countries may be most affected. By using 2011, 2013 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS), our identification strategy uses variation in China's mandatory retirement age with a fuzzy discontinuity design to examine an exogenous shock to retirement behavior. Our study finds that retirement will increase weight and BMI among men. This effect is much larger for men with low education. The channel may be that men with low education drink more and take less vigorous exercises after they get retired. Retirement does not affect weight and BMI for women. These effects are robust with different definitions of retirement, narrow retirement bandwidth for samples as well as dropping samples with rural Hukou.

Changes in sleep duration associated with retirement transitions: The role of naps

This study examined the changes in sleep duration (total sleep time, night-time sleep and daytime naps) after retirement transitions in China using a panel dataset of the China Health and Retirement Longitudinal Study in 2011, 2013 and 2015 with a total of 48,458 respondents. Linear regression analysis with generalized estimating equations was employed to examine the changes in sleep duration after transitions between different types of employment status. After controlling for the confounders, the results showed that the retired population and the population working in agricultural sectors slept 8.02 (p < .01) and 5.19 (p < .01) minutes longer than the population working in non-agricultural sectors, respectively. Employment transition also had significant effects on sleep duration. Transition from non-agricultural sectors to retirement increased total sleep time by 13.58 (p < .01) minutes and also raised the probability of daytime naps by 18% (OR = 1.18, p < .01). Transition from agricultural employment to retirement did not significantly affect the total sleep time, but significantly increased the probability of daytime naps (OR = 1.12, p = .02). Reentering the non-agricultural sectors for the retirees did not significantly affect night-time sleep, but decreased the probability of daytime naps (OR = 0.73, p < .01) and daytime nap duration (by 5.26 min, p = .01). In conclusion, people in China increased their sleep duration after transitions to retirement, but the magnitudes were much smaller than those in Western countries. Differences may be attributed to an abundant amount of Chinese people working in agricultural sectors, the high volume of retired people reentering the work force and the large proportion of people in China that had daytime naps at baseline.

The effect of retirement on elderly cognitive functioning

Cognitive functioning exhibits a clear lifecycle pattern with a general deterioration over older ages. This article estimates the short-term effect of retirement on cognitive performance of elderly Australians by exploiting the exogenous variation in retirement decisions induced by changes in social security eligibility rules. The empirical results show that on average retirement has a negative but modest effect on cognition, and the rate of cognitive decline with age is greater for men than women. The results for women display no significant effects on working memory and speed of information processing. The article further adds to the literature by providing evidence on the possible mechanisms through which retirement could affect individual's cognitive performance. We find that moving into retirement leads women to increase the time spent in mental and household activities, which may in part explain the modest effect we observe for women.

Sick of retirement?

This paper examines the causal effect of retirement on health and healthcare utilization using two identification strategies on Danish full population data. First, I use a reform of the statutory retirement age in an IV design. Second, I use a large discontinuity in retirement take-up at the earliest age of retirement (60) in a regression discontinuity design. The results show that early retirement leads to decreases in GP visits and hospitalizations of 8-10% in the short run. The reduction in GP visits is driven by a drop in female GP utilization, while both genders contribute equally to the decline in hospitalizations. Early retirement has no effect on health measured by comorbidities or mortality. Statutory retirement has no effect on health or healthcare utilization. The results suggest that gender, age at retirement and complier composition are important sources of heterogeneity.

Retirement and Unexpected Health Shocks

Is retirement good for your health? We complement previous studies by exploring the effect of retirement on unexpected health evolution. Using panel data from the Household, Income and Labour Dynamics in Australia survey (2001-2014), we construct measures of the mismatch between individual expected and actual health evolution (hereafter "health shocks"). In our approach, reverse causation running from health shocks to retirement is highly unlikely, because we look at shocks that happen after retirement, and those shocks are, by definition, unanticipated. We find that retirement decreases the probability of negative shocks (by approximately 16% to 24% for men and 14% to 23% for women) while increasing the likelihood of positive shocks (by 9% to 14% for men and 10% to 13% for women). This result is robust to the use of different lead-lag structures and of alternative measures of health change. Our findings are thus consistent with a positive impact of retirement on health.

Labor market engagement and the body mass index of working adults: Evidence from India

Galvanized by rapid income growth, labor market transitions in the nature of jobs, and lifestyle factors, there has been an increase in rates of obesity in many developing countries. This paper examines the relationship between BMI and sector and physical intensity of work among urban adults in India. We document that BMI is positively and significantly associated with labor market inactivity. Women in white-collar work have about 1.01 kg/m² higher BMI than women in blue-collar work. For working men, the comparable estimate is approximately 1.18 kg/m². We find that the increase in overall BMI originates from those who are already at high levels of BMI. Further, relative to the non-working sample, employment in a blue-collar occupation is associated with a BMI penalty for men and women. We find suggestive evidence that the increase in BMI for women is driven by a decline in energy expenditure, while both a decrease in energy expenditure and an increase in energy intake are important in explaining BMI dynamics for men. These results are robust to a variety of specification and methodological checks, and suggest that the increasing trend in BMI may be attributed to the transition towards a more sedentary occupational structure. Overall our research underlines the important role played by occupational engagement in determining the general health of populations in developing countries.

The effect of retirement on healthcare utilization: Evidence from China

We examine the effect of retirement on healthcare utilization in China using longitudinal data. We use a nonparametric fuzzy regression discontinuity design, exploiting the statutory retirement age in urban China as a source of exogenous variation in retirement. In contrast to previous results for developed countries, we find that in China retirement increases healthcare utilization. This increase can be attributed to deteriorating health and in particular to the reduced opportunity cost of time after retirement. For the sample as a whole, income is not a dominating mechanism. People with low education, however, are more likely to forego recommended inpatient care after retirement.

Why are women slimmer than men in developed countries?

Women have a lower BMI than men in developed countries, yet the opposite is true in developing countries. We call this the gender BMI puzzle and investigate its underlying cause. We begin by studying time trends in Japan, where, consistent with the cross-country puzzle, the BMI of adult women has steadily decreased since the 1950s, whereas the BMI of adult men has steadily increased. We study how changes in energy intake and energy expenditure account for the over-time gender BMI puzzle using the Japanese National Nutrition Survey from 1975 to 2010, which provides nurse-measured height and weight and nutritionist-assisted food records. Because long-term data on energy expenditure do not exist, we calculate energy expenditure using a steady-state body weight model. We then conduct cross-country regression analysis to corroborate what we learn from the Japanese data. We find that both energy intake and energy expenditure have significantly decreased for Japanese adult men and women and that a larger reduction in energy expenditure among men than women accounts for the increasing male-to-female BMI gap. Trends in BMI and energy expenditure vary greatly by occupation, suggesting that a relatively large decrease in physical activity in the workplace among men underlies the gender BMI puzzle. The cross-country analysis supports the generalizability of the findings beyond the Japanese data. Furthermore, the analysis suggests the increasing male-to-female BMI gap is driven not only by a reduction in the energy requirements of physically demanding work but also by weakening occupational gender segregation. No support is found for other explanations, such as increasing female labor force participation, greater female susceptibility to malnutrition in utero, and gender inequality in nutrition in early life.

Healthy behaviours and productive activities among Thai older adults: A repeated cross-sectional analysis

Based on a nationally representative repeated cross-sectional sample of older individuals from the 2007 and 2011 Surveys of Older Persons in Thailand (n = 50,138, with the participation rate of 95.79%), this study investigates the extent to which healthy behaviours are interrelated with productive activities in old age. Healthy behaviours were represented by alcohol abstinence, tobacco abstinence, physical exercise, and consumption of a nutritious diet, encompassing all major lifestyle choices that could lower mortality risks among the general population. Productive activities were represented by social participation and labour participation, consistent with the paradigms of Active and Productive Ageing promoted by the World Health Organization. A multivariate probit model, whereby all six behaviours were jointly estimated, was explored. Conditional on pairwise combinations of the two productive activities, the probabilities of contemporaneously undertaking all four healthy behaviours were calculated. The results illustrate that the relationships among productive activities and health behaviours are inextricable and complex. Considering each of the four healthy behaviours separately, social participation and labour participation are associated with lower probabilities of abstaining from alcohol and tobacco but higher probabilities of exercising and keeping a nutritious diet among older adults. Considering all four healthy behaviours together, the productive activities are associated with a significant increase in the probability that a Thai older adult would simultaneously abstain from alcohol, abstain from tobacco, exercise, and eat healthily, compared to if the same individual undertakes neither social participation nor labour participation. This study calls for a consistent set of multiple-behaviour interventions to promote healthy and productive ageing.

Does postponing minimum retirement age improve healthy behaviors before retirement? Evidence from middle-aged Italian workers

By increasing the residual working horizon of employed individuals, pension reforms that rise minimum retirement age can affect individual investment in health-promoting behaviors before retirement. Using the expected increase in minimum retirement age induced by a 2004 Italian pension reform and a difference-in-differences research design, we show that middle-aged Italian males affected by the reform reacted to the longer working horizon by increasing regular exercise, with positive consequences for obesity and self-reported satisfaction with health.

Your retirement and my health behavior: Evidence on retirement externalities from a fuzzy regression discontinuity design

This paper presents evidence on intra-household retirement externalities by assessing the causal effect of spousal retirement on various health behaviors and health status across 19 European countries. We identify partner's and own retirement effects by applying a fuzzy regression discontinuity design using retirement eligibility as exogenous instruments for spousal and own retirement status. We find significant increases in the frequency and intensity of alcohol consumption combined with a significant decrease in moderate physical activities as a response to partner's retirement. In line with the existing literature, we find that own retirement has significant positive effects on engaging in moderate and vigorous physical activities but also leads to a significant increase in the frequency of alcohol intake. Overall, subjective health is negatively affected by spousal retirement and positively by own retirement.

Work, retirement, and muscle strength loss in old age

Reduced muscle strength is an accurate predictor of functional limitations, disability, and mortality. Hence, understanding which socio-economic factors contribute to preserve muscle strength in old age is central to the design of social policies that help reducing these health risks. Using data on handgrip strength collected by the Survey of Health, Ageing and Retirement in Europe for the population of Europeans aged 50+ and the exogenous variation in pension eligibility age across countries over time, we estimate that the retirement transition has a short-term positive causal effect on muscle strength. However, this protective effect is not persistent, as retirement speeds up the age-related trend in muscle strength loss, especially for blue-collar workers and males. The "holy grail" of early retirement may not be such a good deal for retirees' longevity and physical functioning late in life.

The causal effect of retirement on mortality: Evidence from targeted incentives to retire early

This paper estimates the impact of early retirement on mortality using Dutch administrative micro panel data. An unexpected temporary decrease in the eligibility age for retirement benefits for civil servants is used to instrument the retirement choice. We find that induced early retirement decreased the probability that a man dies within 5 years by 2.6 percentage points. The result is robust to alternative specifications and data selection criteria.

Healthier lifestyles after retirement in Europe? Evidence from SHARE

This paper investigates changes in health behaviours upon retirement, using data drawn from the Survey of Health Ageing and Retirement in Europe. By exploiting changes in eligibility rules for early and statutory retirement, we identify the causal effect of retiring from work on smoking, alcohol drinking, engagement in physical activity and visits to the general practitioner or specialist. We provide evidence about individual heterogeneous effects related to gender, education, net wealth, early-life conditions and job characteristics. Our main results--obtained using fixed-effect two-stage least squares--show that changes in health behaviours occur upon retirement and may be a key mechanism through which the latter affects health. In particular, the probability of not practicing any physical activity decreases significantly after retirement, and this effect is stronger for individuals with higher education. We also find that different frameworks of European health care systems (i.e. countries with or without a gate-keeping system to regulate the access to specialist services) matter in shaping individuals' health behaviours after retirement. Our findings provide important information for the design of policies aiming to promote healthy lifestyles in later life, by identifying those who are potential target individuals and which factors may affect their behaviour. Our results also suggest the importance of policies promoting healthy lifestyles well before the end of the working life in order to anticipate the benefits deriving from individuals' health investments.

The dynamic impact of retirement on health: Evidence from a nationwide ten-year panel survey in Japan

Retirement is a major life-course transition that is closely related to changes in health. This study examined the dynamic impact of retirement on health and health behaviors, distinguishing an immediate change in the level of health at retirement and a change in the rate of change after retirement. We used panel data from 9283 individuals (4441 men and 4842 women) who had retired during a nationwide ten-year panel survey in Japan conducted in 2005-2014. We focused on three health behaviors (current smoking, heavy alcohol drinking, and leisure-time physical activity) and two health indicators (self-rated health and psychological distress). We estimated regression models that controlled for both time-invariant individual attributes and the endogeneity of retirement, using panel data collected during the five years before and after retirement. Results generally confirmed that the transition was accompanied by favorable changes in health and health behaviors with some gender differences. Among men, retirement immediately promoted leisure-time physical activity and reduced poor self-rated health and psychological distress. Retirement also accelerated smoking cessation and leisure-time physical activity and decelerated reporting poor health. Among women, retirement immediately promoted leisure-time physical activity and reduced psychological distress, while it did not affect the rate of change in any health variable after retirement. The current study underscores the need for more in-depth knowledge of the dynamic impact of retirement on health. This will assist in developing policy measures to help the middle-aged population make healthy transitions from work to retirement.

Retirement blues

This paper analyses the short- and longer-term effects of retirement on mental health in ten European countries. It exploits thresholds created by state pension ages in an individual-fixed effects instrumental-variable set-up, borrowing intuitions from the regression-discontinuity design literature, to deal with endogeneity in retirement behaviour. The results display no short-term effects of retirement on mental health, but a large negative longer-term impact. This impact survives a battery of robustness tests, and applies to women and men as well as people of different educational and occupational backgrounds similarly. Overall, the findings suggest that reforms inducing people to postpone retirement are not only important for making pension systems solvent, but with time could also pay a mental health dividend among the elderly and reduce public health care costs.

Change in body mass index during transition to statutory retirement: an occupational cohort study

BACKGROUND

Retirement is a major life transition affecting health behaviors. The aim of this study was to examine within-individual changes in body mass index (BMI) during transition from full-time work to statutory retirement by sex and physical work characteristics.

METHODS

A multiwave cohort study repeated every 4 years and data linkage to records from retirement registers. Participants were 5426 Finnish public-sector employees who retired on a statutory basis in 2000-2011 and who reported their body weight one to three times prior to (w-3, w-2, w-1), and one to three times after (w+1, w+2, w+3) retirement.

RESULTS

During the 4-year retirement transition (w+1, vs. w-1) men showed decline in BMI, which was most marked among men with sedentary work (-0.18 kg/m2, 95% CI -.30 to -0.05). In contrast, BMI increased during retirement transition in women and was most marked among women with diverse (0.14 kg/m2, 95% CI 0.08 to 0.20) or physically heavy work (0.31 kg/m2, 95% CI 0.16 to 0.45). Physical activity during leisure time or commuting to work, alcohol consumption or smoking did not explain the observed changes during retirement transition.

CONCLUSIONS

In this study statutory retirement was associated with small changes in BMI. Weight loss was most visible in men retiring from sedentary jobs and weight gain in women retiring from diverse and physically heavy jobs.