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Multi-morbidity and the transition out of full-time paid employment: A longitudinal analysis of the Health and Retirement Study

van Zon, S. K. R., Reijneveld, S. A., Galaurchi, A., Mendes de Leon, C. F., Almansa, J. & Bültmann, U., 2019, In : The Journals of Gerontology. Series B: Psychological Sciences and Social Sciences. 40 p.

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  • Multi-morbidity and the transition out of full-time paid employment

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OBJECTIVES: This study aims to examine whether older workers aged 50-64 years with multi-morbidity are at increased risk to transition from full-time paid employment to part-time employment, partial retirement, unemployment, disability, economic inactivity, full retirement or die than workers without a chronic health condition and workers with one chronic health condition, and whether socioeconomic position (SEP) modifies these transitions.

METHOD: Using data from the Health and Retirement Study (1992 to 2014; n=10,719), sub-distribution hazard ratios with 95% confidence intervals were calculated with a time-varying Fine and Gray competing-risks survival regression model to examine exit from full-time paid employment. We investigated the modifying effect of SEP by examining its interaction with multi-morbidity.

RESULTS: Workers with multi-morbidity had a higher risk of transitioning to partial retirement (1.45; 1.22, 1.72), disability (1.84; 1.21, 2.78) and full retirement (1.63; 1.47, 1.81), and they had a higher mortality risk (2.58; 1.71, 3.88) than workers without chronic disorders. Compared to workers with one chronic health condition, workers with multi-morbidity had an increased risk for partial (1.19; 1.02, 1.40) and full retirement (1.29; 1.17, 1.42), and mortality (1.49; 1.09, 2.04). Only SEP measured as educational level modified the relationship between multi-morbidity and mortality.

DISCUSSION: Workers with multi-morbidity seem more prone to leave full-time paid employment than workers without or with one a chronic health condition. Personalized work accommodations may be necessary to help workers with multi-morbidity prolong their working life.

Original languageEnglish
Number of pages40
JournalThe Journals of Gerontology. Series B: Psychological Sciences and Social Sciences
Publication statusE-pub ahead of print - 2019

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