Department of Public Health, Falk College, Syracuse University, Syracuse, NY, USA.
MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Eur J Public Health. 2022 Feb 1;32(1):52-58. doi: 10.1093/eurpub/ckab170.
The relationship between job insecurity, chronic health conditions (CHCs) and retirement among older workers are likely to differ between countries that have different labor markets and health and social safety nets. To date, there are no epidemiological studies that have prospectively assessed the role of job insecurity in retirement incidence, while accounting for CHC trajectories in two countries with different welfare systems. We investigated the strength of the association between baseline job insecurity and retirement incidence over an 11-year period while accounting for CHC trajectories, among workers 50-55 years of age at baseline in the UK and USA.
We performed Cox proportional hazards regression analysis, using 2006-2016 data from the Health and Retirement Study (US cohort, n = 570) and English Longitudinal Study on Aging (UK cohort n = 1052).
Job insecurity was associated with retirement after adjusting for CHC trajectories (HR = 0.69, 95% CI = 0.50-0.95) in the UK cohort only. CHC trajectories were associated with retirement in both cohorts; however, this association was attenuated in the US cohort, but remained significant for the medium-increasing trajectory in the UK cohort (HR = 1.41, 95% CI = 1.01-1.97) after adjustment for all covariates. Full adjustment for relevant covariates attenuated the association between job insecurity and retirement indicating that CHCs, social and health factors are contributing mechanistic factors underpinning retirement incidence.
The observed differences in the two cohorts may be driven by macro-level factors operating latently, which may affect the work environment, health outcomes and retirement decisions uniquely in different settings.
工作不安全感、慢性健康状况（CHC）和老年人退休之间的关系可能因国家之间不同的劳动力市场和健康与社会安全网而有所不同。迄今为止，尚无前瞻性研究评估工作不安全感在两个福利制度不同的国家的 CHC 轨迹情况下对退休发生率的作用。我们调查了在基线工作不安全感与在英国和美国的基线年龄为 50-55 岁的工人在 11 年期间退休发生率之间的关联强度，同时考虑了 CHC 轨迹。
我们使用来自健康与退休研究（美国队列，n=570）和英国老龄化纵向研究（英国队列，n=1052）的 2006-2016 年数据进行 Cox 比例风险回归分析。
在英国队列中，仅在调整 CHC 轨迹后，工作不安全感与退休相关（HR=0.69，95%CI=0.50-0.95）。在两个队列中，CHC 轨迹都与退休相关；但是，在美国队列中，这种关联减弱了，但在英国队列中，对于中等增加的轨迹，这种关联仍然显著（HR=1.41，95%CI=1.01-1.97），调整所有协变量后。对所有相关协变量进行充分调整，削弱了工作不安全感与退休之间的关联，表明 CHC、社会和健康因素是构成退休发生率的潜在机制因素。
两个队列之间观察到的差异可能是由潜在作用的宏观水平因素驱动的，这些因素可能以不同的方式影响工作环境、健康结果和退休决策。
