by Giuseppe Costa – Department of Clinical and Biological Sciences, University of Turin; Angelo D’Errico – Suprazonal Epidemiology Service, ASL TO3, Piedmont Region; Michelangelo Philippi – Suprazonal Epidemiology Service, ASL TO3, Piedmont Region; Darius Fontana – Suprazonal Epidemiology Service, ASL TO3, Piedmont Region; Roberto Leombruni – Department of Economics and Statistics “Cognetti De Martiis”, University of Turin
“Do you want to live long and healthy? Never stop working!” This is the incipit of the Computer room Of Milena Gabanelli published on Corriere della Sera of 15 May 2023, which has the merit of drawing attention to a very important aspect in the debate on work, pensions and aspects related to the health (physical and mental) of the increasingly elderly population. The question, in summary, is: to lengthen the working career, beyond the retirement age, Is it good, bad or bad for your health?
To balance the increase in life expectancy that has occurred in recent decades in most developed countries, many governments have raised the statutory retirement age or tightened retirement requirements, reducing or eliminating early retirement opportunities. Thus, it is important to establish whether retirement age has a positive or negative (or none) effect on workers’ physical and mental health in the post-retirement period.
Concerning mental health, the main literature reviews agree that after retirement decreases the risk of depression and improves the level of mental well-being, while for physical health the evidence for a positive or negative effect appears mixed and inconclusive.
In studying this phenomenon it must be taken into account that the workers who continue to work at an older age are on average healthier of those who retire earlier (this is the well-known “healthy worker” effect). In fact, the state of health is an important factor that a worker considers when he decides whether or not to retire from work, and becomes even more relevant in those jobs characterized by intense physical work and from exposure to organizational stressors, such as high repetitiveness, high pace and shift work. If differences in health status are not taken into account already existing upon retirement, all studies like the one reviewed will show that those who continue to work are better off than those who retire, a difference that existed before and cannot be attributed to transition from work to retirement.
To overcome this problem, many studies have employed a quasi-experimental design, exploiting changes in the retirement age determined by legislative changes, which, being independent of workers’ decisions and their pre-existing health, allow to compare the state of health (or mortality ) among workers on whom the reform of pension rules has had a different impact. However, even this type of study, which is the most solid from a methodological point of view, has found results contradictory among them, with some studies showing a beneficial effect, others a harmful effect, others no effect on mortality and the incidence of cardiovascular diseases, which are the main cause of death in Italy and in developed countries.
The definition of causal links is therefore complex issue to define and estimate, and the study cited in the Dataroom, according to the same authors, does not have this aim: “This study used aggregate cross-sectional data and therefore It is not possible make causal inferences” (Kachan et al., 2015; p. 4). It is therefore a study which, due to its methodological characteristics, cannot provide any knowledge on the health consequences of different retirement ages.
Scientific data should be shown to the public in all its nuances, avoiding simplifications which are good for supporting appealing arguments for communication (such as the one that basically it would be better to continue working), but which are of little use in helping the public form a valid opinion; in this way, among other things, there is also the risk of reinforcing that feeling of delegitimization that science lives in this historical phase in the eyes of the public.
For the reader who wants to deepen the scientific literature on the subject, we recommend some exemplary titles of the divergences that exist on the subject matter, on which we base our comment:
– Odone A, et al., Does retirement trigger depressive symptoms? A systematic review and meta-analysis. Epidemiol Psychiatr Sci. 2021; 30: e77.
van der Heide I, et al. Is retirement good for your health? A systematic review of longitudinal studies. BMC Public Health. 2013; 13:1180.
– Hernaes E, et al. Does retirement age impact mortality? J Health Econ. 2013;32(3):586-98. Hagen J. The effects of increasing the normal retirement age on health care utilization and mortality. J Popul Econ. 2018;31(1): 193-234.
– Ardito C, et al. To work or not to work? The effect of higher pension age on cardiovascular health. Ind Relat 2020; 59(3): 399-434.
– Hallberg D, et al. Is an early retirement offer good for your health? Quasi-experimental evidence from the army. J Health Econ. 2015; 44:274-85.
– Bozio A, et al. Impact of later retirement on mortality: Evidence from France. Health Econ. 2021;30(5):1178-1199.
– Kuhn A, et al. Fatal attraction? Extended unemployment benefits, labor force exits, and mortality. J Public Econ. 2020; 191: 104087.
– Behncke S. Does retirement trigger ill health? Health Econ. 2012, 21(3): 282-300.