Abstract
BackgroundEmployment histories influence health. However, most studies have so far investigated cross-sectional associations between employment histories and health, failing to recognize health as a dynamic process in later life.MethodsWe use Waves 3–8 of the English Longitudinal Study of Ageing, including retrospective information on respondents’ employment activities. We used dynamic hamming distances to summarize lifetime employment histories up to state pension age (64 for men and 59 for women). Multilevel growth curve models were then used to estimate the influence of lifetime employment histories on later life health trajectories over a 10-year period using quality of life (QoL), somatic health, and depression.ResultsNet of selection effect and a host of contemporaneous material and social resources, men who exited early started off with poorer health than those with continuous attachment to the labour market but had a very similar health profile by the end of the 10-year period considered. Among women, better somatic health and higher QoL were observed among those who had employment breaks for family care, and this health advantage was maintained over time. Lifetime employment histories are not related to depression for either men or women.ConclusionOverall, differences in health by employment histories level off only among men who left earlier and those continuously employed. Flexible arrangements for men in poor health who benefit from leaving the labour market early and supporting women who wish to take breaks for family care may help reduce health inequalities in later life.
Highlights
Research has consistently shown a positive relationship between paid work and health: at any given point, employed individuals report better health than the unemployed individuals or those out of the labour force[1] but in this, mainly cross-sectional work, neither work nor health are considered as a dynamic processes varying over time
Those who combine shorter periods of family care with strong labour market attachment are healthier in their mid-50s than those who spend longer periods of time out of the labour market,[4] and their risk of mortality and disability at older ages is lower compared with their counterparts with histories of continuous paid work or absence from the labour market,[9] but this may differ in different national contexts.[15]
Our study investigates the associations between lifetime employment histories up to state pension age (SPA) and 10-year trajectories of three measures of health (QoL, somatic health, and depression) among men and women post-SPA in England, taking account of selection effects and contemporaneous material and social factors
Summary
Research has consistently shown a positive relationship between paid work and health: at any given point, employed individuals report better health than the unemployed individuals or those out of the labour force[1] but in this, mainly cross-sectional work, neither work nor health are considered as a dynamic processes varying over time. Studies show that men with continuous labour market attachment across the ‘working years’ report more favourable health than their counterparts with relatively weak ties.[5,10] Among women, those who combine shorter periods of family care with strong labour market attachment are healthier in their mid-50s than those who spend longer periods of time out of the labour market,[4] and their risk of mortality and disability at older ages is lower compared with their counterparts with histories of continuous paid work or absence from the labour market,[9] but this may differ in different national contexts.[15] Women who interrupt paid work with breaks for family care, followed by employment up to SPA, report the highest quality of life (QoL) in later life.[5] For women, occupying multiple roles has been shown to be health enhancing[16,17] but temporarily interrupting employment to care for young families may confer social benefits, such as the avoidance of role burden, which could have an enduring effect on health Both men and women with stronger ties to the labour market may be more likely to have accumulated material (e.g. wealth, pension entitlements, home ownership) and social resources (e.g. healthenhancing connections) which favour better health post-SPA.[18]
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