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

Abstract

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.