Astrid de Wind

Health, job characteristics, skills, and social and financial factors in relation to early retirement – results from a longitudinal study in the Netherlands

OBJECTIVES This study aimed to investigate the relative contribution of health, job characteristics, skills and knowledge, and social and financial factors to the transition from work to (non-disability) early retirement. METHODS Employees aged 59-63 years (N=2317) were selected from the Study on Transitions in Employment, Ability and Motivation in the Netherlands (STREAM). Individual characteristics, health, job characteristics, skills and knowledge, and social and financial factors were measured using a questionnaire at baseline. Information on early retirement was derived from the one-year follow-up questionnaire. Logistic regression analyses were used to identify predictors of early retirement. Population Attributable Fractions (PAF) were calculated. RESULTS Older age [odds ratio (OR) 1.79], poor physical health (OR 1.78), a positive attitude of the partner with respect to early retirement (OR 3.85), and the financial possibility to stop working before the age of 65 (OR 10.2) predicted the transition to early retirement, whereas employees that reported high appreciation at work (OR 0.58) and higher focus on development of skills and knowledge (OR 0.54) were less likely to retire early. PAF were 0.75 for the financial possibility to stop working, 0.43 for a positive attitude of the partner with respect to early retirement, 0.27 for low appreciation at work, 0.23 for a low focus on development, and 0.21 for poor health. CONCLUSIONS The financial possibility to stop working before the age of 65 importantly contributes to early retirement. In the context of rapidly diminishing financial opportunities to retire early in the Netherlands, the prolongation of working life might be promoted by workplace health promotion and disability management, and work-related interventions focusing on appreciation and the learning environment.

The influence of chronic health problems and work-related factors on loss of paid employment among older workers

Background With an ageing society and increasing retirement ages, it is important to understand how employability can be promoted in older workers with health problems. The current study aimed to determine whether (1) different chronic health problems predict transitions from paid employment to disability benefits, unemployment and early retirement, and (2) how work-related factors modify these associations. Methods Self-report questionnaire data was used from the Dutch longitudinal Study on Transitions in Employment, Ability and Motivation with 3 years of follow-up (2010–2013), among employees aged 45–64 years (N=8149). The influence of baseline chronic health problems and work-related factors on transitions from paid employment to disability benefits, unemployment and early retirement during follow-up was estimated in a competing risks proportional hazards model. Relative excess risk of transitions due to the interaction between chronic health problems and work-related factors was assessed. Results Severe headache, diabetes mellitus and musculoskeletal, respiratory, digestive and psychological health problems predicted an increased risk of disability benefits (HR range 1.78–2.79). Circulatory (HR=1.35) and psychological health problems (HR=2.58) predicted unemployment, and musculoskeletal (HR=1.23) and psychological health problems (HR=1.57) predicted early retirement. Work-related factors did not modify the influence of health problems on unemployment or early retirement. Psychosocial work-related factors, especially autonomy, modified the influence of health problems on disability benefits. Specifically, among workers with health problems, higher autonomy, higher support and lower psychological job demands reduced the risk of disability benefits by 82%, 49%, and 11%, respectively. Conclusions All health problems affected disability benefits to a similar extent, but psychological health problems especially predicted unemployment and early retirement. For older workers with health problems, promoting an optimal work environment has the potential to contribute to sustainable employment.

The role of ability, motivation, and opportunity to work in the transition from work to early retirement - testing and optimizing the Early Retirement Model

OBJECTIVES Determinants in the domains health, job characteristics, skills, and social and financial factors may influence early retirement through three central explanatory variables, namely, the ability, motivation, and opportunity to work. Based on the literature, we created the Early Retirement Model. This study aims to investigate whether data support the model and how it could be improved. METHODS Employees aged 58-62 years (N=1862), who participated in the first three waves of the Dutch Study on Transitions in Employment, Ability and Motivation (STREAM) were included. Determinants were assessed at baseline, central explanatory variables after one year, and early retirement after two years. Structural equation modeling was applied. RESULTS Testing the Early Retirement Model resulted in a model with good fit. Health, job characteristics, skills, and social and financial factors were related to the ability, motivation and/or opportunity to work (significant β range: 0.05-0.31). Lower work ability (β=-0.13) and less opportunity to work (attitude colleagues and supervisor about working until age 65: β=-0.24) predicted early retirement, whereas the motivation to work (work engagement) did not. The model could be improved by adding direct effects of three determinants on early retirement, ie, support of colleagues and supervisor (β=0.14), positive attitude of the partner with respect to early retirement (β=0.15), and not having a partner (β=-0.13). CONCLUSIONS The Early Retirement Model was largely supported by the data but could be improved. The prolongation of working life might be promoted by work-related interventions focusing on health, work ability, the social work climate, social norms on prolonged careers, and the learning environment.

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.

Predicting working beyond retirement in the Netherlands: an interdisciplinary approach involving occupational epidemiology and economics

Objectives No study so far has combined register-based socioeconomic information with self-reported information on health, demographics, work characteristics, and the social environment. The aim of this study was to investigate whether socioeconomic, health, demographic, work characteristics and social environmental characteristics independently predict working beyond retirement. Methods Questionnaire data from the Study on Transitions in Employment, Ability and Motivation were linked to data from Statistics Netherlands. A prediction model was built consisting of the following blocks: socioeconomic, health, demographic, work characteristics and the social environment. First, univariate analyses were performed (P0<.15), followed by correlations and logistic multivariate regression analyses with backward selection per block (P0<.15). All remaining factors were combined into one final model (P0<.05). Results In the final model, only factors from the blocks health, work and social environmental characteristics remained. Better physical health, being intensively physically active for >2 days/week, higher body height, and working in healthcare predicted working beyond retirement. If respondents had a permanent contract or worked in handcraft, or had a partner that did not like them to work until the official retirement age, they were less likely to work beyond retirement. Conclusion Health, work characteristics and social environment predicted working beyond retirement, but register-based socioeconomic and demographic characteristics did not independently predict working beyond retirement. This study shows that working beyond retirement is multifactorial.

One-year Predictors of Presenteeism in Workers with Rheumatoid Arthritis: Disease-related Factors and Characteristics of General Health and Work

Objective. Rheumatoid arthritis (RA) affects adults of working age and leads to productivity losses because of presenteeism that results from limitations while at work. The aim of our study was to gain insight into disease-related factors, general health, and work characteristics as predictors of presenteeism in workers with RA. Methods. Workers with RA (n = 150) recruited by rheumatologists completed questionnaires at baseline and after 1 year. Medical information was retrieved from patient records. Presenteeism was measured by the Work Limitations Questionnaire. Disease [28-joint Disease Activity Score (DAS28), Health Assessment Questionnaire (HAQ), pain, fatigue], general health (mental, physical, deterioration of health), and work characteristics (work instability, social support, workload) were assessed as predictors of presenteeism after 1 year using linear regression analyses. Results. Presenteeism was 4.0 h over a 2-week period based on an average work week of 28.7 hours. More RA-related disability (HAQ; B = −1.20, 95% CI −2.12 to −0.28), poorer mental health (B = −0.04, 95% CI −0.08 to −0.01), and health deterioration over a 1-year period (B: −0.02, 95% CI −0.04 to −0.01) were associated with more presenteeism. Work characteristics were not associated with presenteeism. Conclusion. Disease-related factors and general health characteristics were significantly associated with presenteeism at 1-year followup, although the effects of the general health characteristics were considered not to be relevant. To reduce presenteeism and improve functioning at work, it is important to pay attention to reducing RA-related disability in addition to reducing disease activity. A broader perspective is needed and should also take into account the level of RA-related disability.

Do Work Characteristics Predict Health Deterioration Among Employees with Chronic Diseases

Purpose In our ageing workforce, the increasing numbers of employees with chronic diseases are encouraged to prolong their working lives. It is important to prevent health deterioration in this vulnerable group. This study aims to investigate whether work characteristics predict health deterioration over a 3-year period among employees with (1) chronic diseases, and, more specifically, (2) musculoskeletal and psychological disorders. Methods The study population consisted of 5600 employees aged 45–64 years with a chronic disease, who participated in the Dutch Study on Transitions in Employment, Ability and Motivation (STREAM). Information on work characteristics was derived from the baseline questionnaire. Health deterioration was defined as a decrease in general health (SF-12) between baseline and follow-up (1–3 years). Crude and adjusted logistic regression analyses were performed to investigate prediction of health deterioration by work characteristics. Subgroup analyses were performed for employees with musculoskeletal and psychological disorders. Results At follow-up, 19.2% of the employees reported health deterioration (N = 1075). Higher social support of colleagues or supervisor predicted health deterioration in the crude analyses in the total group, and the groups with either musculoskeletal or psychological disorders (ORs 1.11–1.42). This effect was not found anymore in the adjusted analyses. The other work characteristics did not predict health deterioration in any group. Conclusions This study did not support our hypothesis that work characteristics predict health deterioration among employees with chronic diseases. As our study population succeeded continuing employment to 45 years and beyond, it was probably a relatively healthy selection of employees.

Kunnen chronisch zieken doorwerken tot hun 71ste

SamenvattingVoor wie geboren is na 1954, is de AOW-leeftijd 67 jaar en 3 maanden, of hoger. Vanaf 2022 hangt de AOW-leeftijd namelijk af van hoe oud mensen gemiddeld worden. Volgens een schatting van het CBS zal de AOW-leeftijd in 2060 op 71,5 jaar uitkomen. In 2015 werkten mensen gemiddeld tot 64 jaar en 5 maanden. Wat is de reden dat mensen vroegtijdig stoppen met werken? Wat is de bijdrage van gezondheid en werkkenmerken aan langer doorwerken? En kunnen chronisch zieken eigenlijk wel doorwerken tot hun 71ste?