Horner Elizabeth Mokyr, Cullen Mark R
American Institutes for Research, 2800 Campus Dr. Suite 200, San Mateo, CA, 94330, USA.
Stanford University School of Medicine, Population Health Sciences, MSOB 1265 Welch Road, Stanford, CA, 94305, USA.
BMC Health Serv Res. 2016 Feb 19;16:68. doi: 10.1186/s12913-016-1318-5.
Is retirement good or bad for health? Disentangling causality is difficult. Much of the previous quasi-experimental research on the effect of health on retirement used self-reported health and relied upon discontinuities in public retirement incentives across Europe. The current study investigated the effect of retirement on health by exploiting discontinuities in private retirement incentives to test the effect of retirement on health using a quasi-experimental study design.
Secondary data (1997-2009) on a cohort of male manufacturing workers in a United States setting. Health status was determined using claims data from private insurance and Medicare. Analyses used employer-based administrative and claims data and claim data from Medicare.
Widely used selection on observables models overstate the negative impact of retirement due to the endogeneity of the decision to retire. In addition, health status as measured by administrative claims data provide some advantages over the more commonly used survey items. Using an instrument and administrative health records, we find null to positive effects from retirement on all fronts, with a possible exception of increased risk for diabetes.
This study provides evidence that retirement is not detrimental and may be beneficial to health for a sample of manufacturing workers. In addition, it supports previous research indicating that quasi-experimental methodologies are necessary to evaluate the relationship between retirement and health, as any selection on observable model will overstate the negative relationship of retirement on health. Further, it provides a model for how such research could be implemented in countries like the United States that do not have a strong public pension program. Finally, it demonstrates that such research need-not rely upon survey data, which has certain shortcomings and is not always available for homogenous samples.
退休对健康是好是坏？理清其中的因果关系很困难。此前许多关于健康对退休影响的准实验研究使用的是自我报告的健康状况，并依赖于欧洲各地公共退休激励措施的不连续性。本研究通过利用私人退休激励措施的不连续性来调查退休对健康的影响，采用准实验研究设计来检验退休对健康的影响。
对美国一群男性制造业工人的二手数据（1997 - 2009年）进行研究。使用来自私人保险和医疗保险的理赔数据来确定健康状况。分析使用基于雇主的行政和理赔数据以及医疗保险的理赔数据。
由于退休决策的内生性，广泛使用的可观测变量选择模型夸大了退休的负面影响。此外，行政理赔数据衡量的健康状况比更常用的调查项目具有一些优势。使用一种工具和行政健康记录，我们发现退休在各方面的影响为零至正面，糖尿病风险增加可能是个例外。
本研究提供了证据，表明退休对制造业工人样本并非有害，可能对健康有益。此外，它支持了先前的研究，表明准实验方法对于评估退休与健康之间的关系是必要的，因为任何可观测模型选择都会夸大退休与健康之间的负面关系。此外，它为像美国这样没有强大公共养老金计划的国家如何开展此类研究提供了一个模型。最后，它表明此类研究不必依赖调查数据，调查数据有一定缺点且并非总是可用于同质样本。
