Differential Impact of Involuntary Job Loss on Physical Disability Among Older Workers Does Predisposition Matter?

Characterizing Long-Term Trajectories of Work and Disability Leave: The Role of Occupational Exposures, Health, and Personal Demographics

OBJECTIVE

This article characterizes trajectories of work and disability leave across the tenure of a cohort of 49,595 employees in a large American manufacturing firm.

METHODS

We employ sequence and cluster analysis to group workers who share similar trajectories of work and disability leave. We then use multinomial logistic regression models to describe the demographic, health, and job-specific correlates of these trajectories.

RESULTS

All workers were clustered into one of eight trajectories. Female workers (RR 1.3 to 2.1), those experiencing musculoskeletal disease (RR 1.3 to 1.5), and those whose jobs entailed exposure to high levels of air pollution (total particulate matter; RR 1.9 to 2.4) were more likely to experience at least one disability episode.

CONCLUSIONS

These trajectories and their correlates provide insight into disability processes and their relationship to demographic characteristics, health, and working conditions of employees.

The effects of exit from work on health across different socioeconomic groups: A systematic literature review

Exit from work leads to different effects on health, partially depending on the socioeconomic status (SES) of people in the work exit. Several studies on the effects of exit from work on health across socioeconomic groups have been performed, but results are conflicting. The aim of this review is to systematically review the available evidence regarding the effects of exit from work on health in high and low socioeconomic groups. A systematic literature search was conducted using Pubmed, Embase, Web of Science, CINAHL and PsycINFO. Search terms related to exit from work, health, SES and design (prospective or retrospective). Articles were included if they focused on: exit from work (early/statutory retirement, unemployment or disability pension); health (general, physical or mental health and/or health behaviour); SES (educational, occupational and/or income level); and inclusion of stratified or interaction analyses to determine differences across socioeconomic groups. This search strategy resulted in 22 studies. For general, physical or mental health and health behaviour, 13 studies found more positive effects of exit from work on health among employees with a higher SES compared to employees with a lower SES. These effects were mainly found after early/statutory retirement. In conclusion, the effects of exit from work, or more specific the effects of early/statutory retirement on health are different across socioeconomic groups. However, the findings of this review should be interpreted with caution as the studies used heterogeneous health outcomes and on each health outcome a limited number of studies was included. Yet, the positive effects of exit from work on health are mainly present in higher socioeconomic groups. Therefore, public health policies should focus on improving health of employees with a lower SES, in particular after exit from work to decrease health inequalities.

Economic downturns during the life-course and late-life health: an analysis of 11 European countries

BACKGROUND

Research has shown that individual socio-economic circumstances throughout life affect health in older ages. However, little attention has been paid to the broad economic context affecting individual's life-chances. This paper examines whether economic downturns experienced during young and mid-adulthood have long-run effects on physical health.

METHODS

We exploit data on economic fluctuations in the period 1945-2010 in 11 European countries, linked to longitudinal data from three waves of the Survey of Health, Ageing and Retirement in Europe. We estimate a country fixed effect model assessing whether downturns experienced at 5-year intervals between ages 25 and 54 are associated with levels and onset of new limitations with Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) in older age (55-80).

RESULTS

Experiencing an economic downturn at ages 45-59 is associated with increased risk of having at least one disability limitation in later-life (odds ratio [OR] for ADL = 1.66, 95% CI [Confidence Interval] 1.24, 2.22; OR for IADL = 1.46, 95% CI 1.10, 1.94). Economic downturns at ages 40-44 and 45-49 also increase the risk of a new functional limitation in later-life (OR for IADL ages 40-44 = 1.20, 95% CI 1.03, 1.40; OR for IADL ages 45-49 = 1.44, CI 1.10-1.88). Economic downturns experienced around these ages are also associated with significantly greater risks of smoking and excessive alcohol consumption as well as lower incomes in older age.

CONCLUSIONS

Exposure to an economic downturn at ages 40-49 is associated with poorer health in older ages, possibly by increasing risk of unhealthy behaviours and low incomes persisting into older age.

Unemployment, disability and life expectancy in the United States: A life course study

BACKGROUND

Unemployment may be associated with health through factors including stress, depression, unhealthy behaviors, reduced health care, and loss of social networks. Little is known about associations of total lifetime unemployment with disability and life expectancy.

HYPOTHESIS

People with high unemployment (≥the median) will live shorter lives with more disability than those with less unemployment.

METHODS

Data were nationally representative of African Americans and non-Hispanic whites, from the Panel Study of Income Dynamics (37 waves 1968-2011, n = 7,970, mean work years = 24.7). Seven waves (1999-2011, 58,268 person-years) measured disability in activities of daily living. We estimated monthly probabilities of disability and death associated with unemployment using multinomial logistic Markov models adjusted for age, sex, race/ethnicity, education, health status at baseline and throughout work life, and social support. We used the probabilities to create large populations with microsimulation, each individual having known monthly disability status, age 40 to death. We analyzed the populations to measure outcomes.

RESULTS

Respectively for African American and white women and African American and white men, life expectancies (with 95% confidence intervals) from age 40 with low unemployment were ages: 77.1 (75.0-78.3), 80.6 (78.4-81.4), 71.4 (69.6-72.5), and 76.9 (74.9-77.9). Corresponding high unemployment results were: 73.7 (71.7-75.0), 77.5 (75.1-78.0), 68.4 (66.8-69.0), and 73.7 (71.5-74.3). The percentage of life disabled from age 40 was greater with high unemployment for the same groups, by 23.9%, 21.0%, 21.3%, and 21.1% (all p < 0.01).

CONCLUSIONS

High lifetime unemployment may be associated with a larger proportion of later life with disability and lower life expectancy.

The Far-Reaching Impact of Job Loss and Unemployment

Job loss is an involuntary disruptive life event with a far-reaching impact on workers' life trajectories. Its incidence among growing segments of the workforce, alongside the recent era of severe economic upheaval, has increased attention to the effects of job loss and unemployment. As a relatively exogenous labor market shock, the study of displacement enables robust estimates of associations between socioeconomic circumstances and life outcomes. Research suggests that displacement is associated with subsequent unemployment, long-term earnings losses, and lower job quality; declines in psychological and physical well-being; loss of psychosocial assets; social withdrawal; family disruption; and lower levels of children's attainment and well-being. While reemployment mitigates some of the negative effects of job loss, it does not eliminate them. Contexts of widespread unemployment, although associated with larger economic losses, lessen the social-psychological impact of job loss. Future research should attend more fully to how the economic and social-psychological effects of displacement intersect and extend beyond displaced workers themselves.

The health effects of US unemployment insurance policy: does income from unemployment benefits prevent cardiovascular disease?

Objective

Previous studies suggest that unemployment predicts increased cardiovascular disease (CVD) risk, but whether unemployment insurance programs mitigate this risk has not been assessed. Exploiting US state variations in unemployment insurance benefit programs, we tested the hypothesis that more generous benefits reduce CVD risk.

Methods

Cohort data came from 16,108 participants in the Health and Retirement Study (HRS) aged 50–65 at baseline interviewed from 1992 to 2010. Data on first and recurrent CVD diagnosis assessed through biennial interviews were linked to the generosity of unemployment benefit programmes in each state and year. Using state fixed-effect models, we assessed whether state changes in the generosity of unemployment benefits predicted CVD risk.

Results

States with higher unemployment benefits had lower incidence of CVD, so that a 1% increase in benefits was associated with 18% lower odds of CVD (OR:0.82, 95%-CI:0.71–0.94). This association remained after introducing US census regional division fixed effects, but disappeared after introducing state fixed effects (OR:1.02, 95%-CI:0.79–1.31).This was consistent with the fact that unemployment was not associated with CVD risk in state-fixed effect models.

Conclusion

Although states with more generous unemployment benefits had lower CVD incidence, this appeared to be due to confounding by state-level characteristics. Possible explanations are the lack of short-term effects of unemployment on CVD risk. Future studies should assess whether benefits at earlier stages of the life-course influence long-term risk of CVD.

Time away from work predicts later cognitive function: differences by activity during leave

PURPOSE

We sought to examine how different activities performed during employment gaps are associated with later cognitive function and change.

METHODS

Five cognitive measures were used to indicate cognitive impairment of 18,259 respondents to the Survey of Health, Ageing, and Retirement in Europe (ages 50-73) in 2004/5 or 2006/7. Using complete employment histories, employment gaps of ≥6 months between ages 25 and 65 were identified.

RESULTS

Controlling for early life socioeconomic status, school performance, and education, higher risk of cognitive impairment was associated with employment gaps described as unemployment (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.04-1.35) and sickness (OR, 1.78; 95% CI, 1.52-2.09). In contrast, lower risk of cognitive impairment was associated with employment gaps described as training (OR, 0.73; 95% CI, 0.52-1.01) or maternity leave (OR, 0.65; 95% CI, 0.57-0.79). In longitudinal mixed effects models, training and maternity leave were associated with lower 2-year aging-related cognitive decline.

DISCUSSION

Periods away from work described as unemployment or sickness are associated with lower cognitive function, whereas maternity and training leaves are associated with better late-life cognitive function. Both causation and selection mechanisms may explain these findings.

Jobless now, sick later? Investigating the long-term consequences of involuntary job loss on health

In the light of the current economic crises which in many countries lead to business closures and mass lay-offs, the consequences of job loss are important on various dimensions. They have to be investigated not only in consideration of a few years, but with a long-term perspective as well, because early life course events may prove important for later life outcomes. This paper uses data from SHARELIFE to shed light on the long-term consequences of involuntary job loss on health. The paper distinguishes between two different reasons for involuntary job loss: plant closures, which in the literature are considered to be exogenous to the individual, and lay-offs, where the causal direction of health and unemployment is ambiguous. These groups are separately compared to those who never experienced a job loss. The paper uses eleven different measures of health to assess long-term health consequences of job loss, which has to have occurred at least 25 years before the current interview. As panel data cannot be employed, a large body of variables, including childhood health and socio-economic conditions, is used to control for the initial conditions. The findings suggest that individuals with an exogenous job loss suffer in the long run: men are significantly more likely to be depressed and they have more trouble knowing the current date. Women report poorer general health and more chronic conditions and are also affected in their physical health: they are more likely to be obese or overweight, and to have any limitations in their (instrumental) activities of daily living. In the comparison group of laid-off individuals, controlling for the initial conditions reduces the effects of job loss on health - proving that controlling for childhood conditions is important.

Have health trends worsened in Greece as a result of the financial crisis? A quasi-experimental approach

BACKGROUND

Health in Greece deteriorated after the recent financial crisis, but whether this decline was caused by the recent financial crisis has not been established. This article uses a quasi-experimental approach to examine the impact of the recent financial crisis on health in Greece.

METHODS

Data came from the European Union Statistics on Income and Living Conditions survey for the years 2006-09. We applied a difference-in-differences approach that compares health trends before and after the financial crisis in Greece with trends in a control population (Poland) that did not experience a recession and had health trends comparable with Greece before the crisis. We used logistic regression to model the impact of the financial crisis on poor self-rated health, controlling for demographic confounders.

RESULTS

Results provide strong evidence of a statistically significant negative effect of the financial crisis on health trends. Relative to the control population, Greece experienced a significantly larger increase in the odds of reporting poor health after the crisis (odds ratio, 1.16; 95% confidence interval, 1.04-1.29). There was no difference in health trends between Poland and Greece before the financial crisis, supporting a causal interpretation of health declines in Greece as a result of the financial crisis.

CONCLUSION

Results provide evidence that trends in self-rated health in Greece worsened as a result of the recent financial crisis. Findings stress the need for urgent health policy responses to the recent economic collapse in Greece as the full impact of austerity measures unfolds in the coming years.

Retirement lost?

In this article, we raise the question as to whether retirement is lost as we currently know and understand it in Canada. With a selected review, we examine retirement research according to the scope of retirement and the new retirement, possible theoretical developments, the timing of transitions into retirement, and life as a retiree including the quality or lack of pensions. Accordingly, we propose that retirement is undergoing modifications on the basis of several trends that commenced before the 2008 economic downturn. The data would appear to lean towards the emergence of a different type of retirement, insofar as the collective Canadian vision of retirement is lost, notwithstanding the economic meltdown in global markets.

The effect of retirement and age at retirement on self-perceived health after three years of follow-up in Dutch 55–64-year-olds

Health consequences of retirement have not been included in the current public debate about increasing the age at retirement, which might be due to the fact that studies aimed at health consequences of retirement show ambiguous results. The literature indicates that various contextual characteristics might explain conflicting results. The current study examines the effect of retirement and age at retirement (55–64 years) on self-perceived health. Characteristics tested for confounding and effect modification were: demographic, health, psychological, job, and retirement characteristics. Subjects were 506 participants in the Longitudinal Aging Study Amsterdam (LASA). After three years, 216 retired and 290 remained employed. Multinomial logistic regression analyses show no main effect for retirement compared to continued employment. Modal (59–60) retirees were more likely to attain excellent or good self-perceived health (less than good self-perceived health as the reference category). Early (55–58) and late (61–64) retirees were unaffected by retirement if they did not receive a disability pension. Early and late retirees who received a disability pension were less likely to attain excellent self-perceived health after retirement. Higher educated were less likely to attain excellent self-perceived health after retirement, especially at late retirement age, although health selection might explain this result. Finally, mastery possibly acts as an adjustment resource. The paper concludes with a discussion on explanations for the effect of retirement and age at retirement.