Falba Tracy A, Sindelar Jody L, Gallo William T
Economics Department, Duke University, Durham, NC, USA.
J Ment Health Policy Econ. 2009 Dec;12(4):175-86.
In this study, we explore whether ex ante work expectations, conditional on work force status at age 62, affect self-reported depressive symptoms at age 62.
Our sample includes 4,387 participants of the Health and Retirement Study, a national longitudinal survey of individuals born between 1931 and 1941, and their spouses. The sample is composed of workers who were less than 62 years of age at the study baseline (1992), and who had reached age 62 by the current study endpoint (2004). This sample enables comparison of realized work status with prior expectations. We estimate the impact of expected work status on self-reported depressive symptoms using negative binomial and logistic regression methods. Sex-stratified regressions are estimated according to full-time work status at age 62. The primary outcome is a summary measure of self-reported depressive symptoms based on a short form of the Center for Epidemiologic Studies-Depression (CES-D) scale. The explanatory variable of interest is the subjective probability of working full-time at the age of 62, reported by participants at the 1992 HRS baseline. We control for baseline socioeconomic and demographic variables as well as life events and changes in macroeconomic conditions that occur within the study timeframe.
Among participants who were not working full time at age 62, we find that men who provided a higher ex ante likelihood of full-time employment at 62 had significantly worse self-reported depressive symptoms than men who provided a lower ex ante likelihood. A similar effect was not found for women. Among participants who were working full time at age 62, we do not find a statistical relationship between ex ante expectations and age-62 self-reported depressive symptoms, for either men or women.
The results suggest that an earlier-than-anticipated work exit is detrimental to mental health for men nearing normal retirement age. Previous research has demonstrated that stress is a causal factor in depression, and a premature labor force departure, which is inconsistent with an individual's cognitive judgment of a suitably timed exit from work, is a psychologically stressful transition that could realistically induce depression. This may be especially true of men, who in this cohort, have stronger labor force attachment than women and tend to define their roles by their occupation. The advantages of the study include nationally representative data, a baseline depression control that circumscribes the effect of endogeneity, and a reasonably long follow-up. Despite our efforts to infer causality, unmeasured factors may account for part of the observed relationship. IMPLICATIONS FOR HEALTH POLICY AND RESEARCH: Depression is a disease that, if untreated, may have serious consequences for behavioral, medical, and social well-being. Our results suggest that further research should aim to estimate the magnitude of clinically severe and mild depression in populations of those who retire earlier than expected, especially for men. Such information could help health care planners and policy makers to direct resources to the mental health needs of men who retire prematurely.
在本研究中,我们探讨以62岁时的劳动力状态为条件的事前工作期望是否会影响62岁时自我报告的抑郁症状。
我们的样本包括4387名健康与退休研究的参与者,这是一项对1931年至1941年出生的个体及其配偶进行的全国性纵向调查。样本由在研究基线(1992年)时年龄小于62岁且到当前研究终点(2004年)时已年满62岁的工作者组成。该样本能够将实际工作状态与先前期望进行比较。我们使用负二项回归和逻辑回归方法估计预期工作状态对自我报告的抑郁症状的影响。根据62岁时的全职工作状态进行性别分层回归。主要结果是基于流行病学研究中心抑郁量表(CES - D)简表的自我报告抑郁症状的汇总指标。感兴趣的解释变量是参与者在1992年健康与退休研究基线时报告的62岁时全职工作的主观概率。我们控制基线社会经济和人口统计学变量以及研究时间范围内发生的生活事件和宏观经济状况变化。
在62岁时未全职工作的参与者中,我们发现,事前预测62岁时全职就业可能性较高的男性,其自我报告的抑郁症状明显比事前预测可能性较低的男性更严重。女性未发现类似影响。在62岁时全职工作的参与者中,我们未发现事前期望与62岁时自我报告的抑郁症状之间存在统计学关系,无论男性还是女性。
结果表明,对于接近正常退休年龄的男性来说,比预期更早退出工作对心理健康有害。先前的研究表明,压力是抑郁症的一个因果因素,过早离开劳动力市场与个人对适时退出工作的认知判断不一致,是一种心理上有压力的转变,实际上可能诱发抑郁症。对于男性来说可能尤其如此,在这个队列中,男性比女性对劳动力的依恋更强,并且倾向于通过职业来定义自己的角色。本研究的优点包括具有全国代表性的数据、限制内生性影响的基线抑郁控制以及相当长的随访期。尽管我们努力推断因果关系,但未测量的因素可能解释了部分观察到的关系。对健康政策和研究的启示:抑郁症是一种疾病,如果不治疗,可能对行为、医疗和社会福祉产生严重后果。我们的结果表明,进一步的研究应旨在估计那些比预期更早退休的人群中临床重度和轻度抑郁症的程度,特别是对于男性。这些信息可以帮助医疗保健规划者和政策制定者将资源导向过早退休男性的心理健康需求。