Short reportTime to retire – Time to die? A prospective cohort study of the effects of early retirement on long-term survival
Introduction
Population aging puts worldwide pressure on unfunded pay-as-you-go pension schemes in which a shrinking number of employees have to pay the expenses for a growing group of pensioners. Recent reforms in many OECD countries stop early retirement (Bonoli and Palier, 2007, OECD, 2007). The financial consequences of these new old-age policies have been widely discussed (Bosworth et al., 2000, Fehr et al., 2003, Schmaehl, 2007). Their health implications, however, have received much less attention. Moreover, studies which have evaluated the general impact of early retirement on survival show mixed outcomes. Several analyses demonstrate that men and women who retire early face higher mortality (Bamia et al., 2008, Ekerdt et al., 1983, Haynes et al., 1978, Karlsson et al., 2007, Morris et al., 1994, Trichopoulos, 1996, Tsai et al., 2005, Wallman et al., 2006). Experts perceive either the retirement phase as a risk factor or illness and frailty as the real reason for a negative selection into early retirement. On the other hand, other studies have detected no survival differences between those who take early retirement and normal pensioners, nor any beneficial effects on health (Litwin, 2007, Padfield, 1996, van Solinge, 2007). According to their argumentation, protection may result from less day-to-day stress and a healthier lifestyle during retirement.
Nevertheless, no study, to our knowledge, has yet attempted to assess selection and protection effects of early retirement simultaneously, although both processes may be taking place at the same time, generating inconsistent results. This is also due to the fact that unbiased population data are not readily available for many countries. For our prospective cohort analysis, we were able to make use of the entire data set from a compulsory German health insurance fund. This allowed us to account for age and overall health status at retirement. We observed 129,675 insured members after their exit from the labor market and discovered selective and protective effects of retirement on their survival.
Section snippets
Subjects, variables, and methods
At present, 85% of the total German population is covered by compulsory health insurance. Nearly 15% of the German population is covered by private health insurance, and only 0.2% of the German population is not insured (Bundesministerium für Gesundheit, 2005, Statistisches Bundesamt, 2007). Our study population includes all the insured members (n = 129,675) of the Gmünder Ersatzkasse (GEK), a compulsory German health insurance fund, who retired between the ages of 50 and 65 from January 1990 to
Results
Owing to their lower labor force participation and the general overrepresentation of men in the GEK, women (n = 41,276) accounted for only one third of the study population (Table 2). Nearly 90% of them left the labor market with an old-age pension, while only 77% of the male population retired due to old age. We observed excess male mortality in all retirement groups, and in all marital and social status classes.
Kaplan–Meier survival curves show highly significant differences in life expectancy
Discussion
Early retirement impacts long-term survival significantly. We observed lower survival chances for persons with poor health at early retirement compared with pensioners who retire later. However, employees who leave the labor market early and healthy may have better survival chances than people retiring between the ages of 61 and 65. This effect is even more pronounced for women.
At first glance, these findings seem contradictory as they provide evidence for detrimental and beneficial effects of
References (28)
- et al.
Age at retirement and mortality in a general population sample
American Journal of Epidemiology
(2008) - et al.
When past reforms open new opportunities: comparing old-age insurance reforms in Bismarckian welfare systems
Social Policy & Administration
(2007) - et al.
Lifetime earnings patterns, the distribution of future social security benefits, and the impact of pension reform
Social Security Bulletin
(2000) - et al.
Love and death in Germany. The marital biography and its effect on mortality
Journal of Marriage & Family
(2004) Statistisches Taschenbuch Gesundheit 2005
(2005)Regression models and life tables (with discussion)
Journal of the Royal Statistical Society
(1972)Reforming early retirement in Europe, Japan and the USA
(2006)- et al.
The effect of retirement on physical health
American Journal of Public Health
(1983) - European Observatory on Health Care Systems. (2000). Health care systems in transition, Germany 2000, Copenhagen: WHO....