(Reuters Health) — People with little education and low socioeconomic status are more likely to leave the workforce in midlife for health reasons than better educated and higher-status workers, suggests a review of research across four developed countries.
In the context of national policies to extend working life by raising retirement ages, the most vulnerable workers may not be capable of working extra years, the study authors write in a report in Occupational & Environmental Medicine, online March 12.
"Population ageing and rising old age dependency ratios have led many governments to increase statutory retirement age," said lead author Ewan Carr of Kings College London in the U.K.
"However, remaining in work until or beyond pensionable age may be challenging for those with low socioeconomic positions," Carr said in an email.
Service industry workers, custodial or sanitation labor and construction jobs are just a few examples of low socioeconomic-status positions that require less education for employment, he said.
"We wanted to find out to what extent people in (these) disadvantaged positions were more likely to stop working at an earlier age than people in more advantaged socioeconomic positions," study coauthor Jenny Head of University College London said in an email.
The researchers analyzed data from seven studies covering a total of 99,164 workers in Finland, France, the U.K. and the U.S. Participants were 48 years old, on average, at the start of the observation period and were followed until they left paid work or until age 64. The studies covered the period between 1989 and 2015.
Health-related labour market exit was defined by voluntarily ceasing paid work due to poor health or disability, assessed through the individual's own report as well as administrative records. Researchers also looked at individuals' self-rated health, their education level and occupation level.
Overall, people with less than a high school education and those with a low-grade occupation were more likely to have poor health than those who had completed post-high school education or with a high-grade occupation (roughly nine per cent versus 4.7 per cent).
During the study, 50,003 workers left the labour force, with 14 per cent of these departures considered to be for health-related reasons. About one in six of those who left for health reasons had less than a high school education.
Across the studies, having a low education level versus a high one was tied to a risk increase of anywhere from 32 percent to 3.5-fold for leaving the workforce early for health reasons.
Similarly, low occupational grade versus high was tied to a risk increase of 61 per cent up to 4.6-fold for leaving the workforce for health reasons.
"Older workers are at greater risk of leaving work due to poor health if they have low level education or work in low grade occupations," Carr said.
The team wasn't surprised by these findings, he noted, since many previous studies have shown an association between socioeconomic position and poor health and between education level and poor health.
"Work-related factors such as these are likely to be associated with early work exit, and health-related exit and would certainly be applicable in the population we studied for this study," he noted.
Public policy could help mitigate this trend by reducing health disparities between high- and low-socioeconomic status workers, said Dr. Peter Muennig, a health policy and management researcher at the Mailman School of Public Health of Columbia University in New York City who was not involved in the study.
"The ideal is to create a situation in which the health gradients are smaller than they are," he said in an email.
"It may be that we can do this with better schools, cheaper education and better welfare benefits," Muennig said. "But no one is 100 per cent sure yet because the experimental data have not been collected. What is clear is that old people in the U.S. are much worse off than anywhere else. And that is doubly true for older people with less educational attainment."
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