Abstract
ObjectiveTo estimate the average treatment effect of working past the current retirement age on the health of Japanese men.MethodsWe used publicly available data from the National Survey of Japanese Elderly, extracting a sample of 1288 men who were 60 years or older. Survey respondents were followed-up for at most 15 years for the onset of four health outcomes: death, cognitive decline, stroke and diabetes. By using the propensity score method, we adjusted for the healthy worker effect by incorporating economic, sociodemographic and health data in the form of independent variables. By calculating the differences in times to a health outcome between those in employment and those not employed, we estimated the average treatment effects on health of being in paid work past retirement age.FindingsCompared with those not employed, those in employment lived 1.91 years longer (95% confidence interval, CI: 0.70 to 3.11), had an additional 2.22 years (95% CI: 0.27 to 4.17) before experiencing cognitive decline, and had a longer period before the onset of diabetes and stroke of 6.05 years (95% CI: 4.44 to 7.65) and 3.35 years (95% CI: 1.42 to 5.28), respectively. We also observed differences between employees and the self-employed: the self-employed had longer life expectancies than employees. In terms of years to onset of diabetes or stroke, however, we only observed significant benefits to health of being an employee but not self-employed.ConclusionOur study found that being in employment past the current age of retirement had a positive impact on health.
Highlights
In response to an ageing population and the associated financial challenges, many countries have introduced extensions to working life; research on the resultant effect on health is currently insufficient
As the age of retirement and condition of health can be interdependent, health selection exists;[12,13] causal inference approaches are required to measure the impact of working past current retirement age on health
Some studies report negative effects on selfrated health, cognitive functioning and depressive syndrome because of retirement;[14,15,16,17] other studies have shown that retirement can lead to improvements in health as indicated by the numbers diagnosed with chronic conditions, activity limitations and self-rated health.[18,19]
Summary
In response to an ageing population and the associated financial challenges, many countries have introduced extensions to working life; research on the resultant effect on health is currently insufficient. Some studies report negative effects on selfrated health, cognitive functioning and depressive syndrome because of retirement;[14,15,16,17] other studies have shown that retirement can lead to improvements in health as indicated by the numbers diagnosed with chronic conditions, activity limitations and self-rated health.[18,19] Only a few studies have accounted for the healthy worker effect when assessing the health consequences of working past retirement age. These studies did not observe any health benefits.[17,20]
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