van der Noordt Maaike, van Tilburg Theo G, van der Pas Suzan, Wouterse Bram, Deeg Dorly J H
Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Department of Health Knowledge Integration, Center for Health and Society, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Arch Public Health. 2023 Feb 6;81(1):16. doi: 10.1186/s13690-022-01008-9.
We examined health trajectories of Dutch older workers across their exit from the workforce in the 1990s, 2000s, and 2010s, testing the hypothesis that pre-post-exit health trajectories of workers with favourable and unfavourable working conditions increasingly diverged over time due to policy measures to extend working life.
The Longitudinal Aging Study Amsterdam includes baseline samples in 1992/1993, 2002/2003 and 2012/2013 with two 3-year follow-up waves each. Selected respondents were aged 55 years and over who exited from a paid job within the first or second 3-year interval, up to and including the statutory retirement age (N = 522). Pre-post-exit trajectories were modelled using Generalized Estimating Equations with outcomes self-rated health and physical limitations and determinants physical demands, psychosocial demands, and psychosocial resources.
Average work exit age rose from 60.7 in the 1990s to 62.9 in the 2010s. On average, self-rated health decreased somewhat over successive periods and did not show pre-post-exit change; average physical limitations increased substantially both over successive periods and from pre- to post-exit. No support is found for our hypothesis. However, regardless of work exposures, we found sharp pre-post-exit increases in physical limitations in the 2010s.
Although these findings provide no support for our hypothesis of diverging health trajectories over time based on work exposure, they show that exiting at a higher age is linked to poorer pre- and post-exit health and to pre-post-exit increases in physical limitations, suggesting greater health care costs in the near future.
我们研究了荷兰老年劳动者在20世纪90年代、21世纪00年代和21世纪10年代退出劳动力市场期间的健康轨迹，检验以下假设：由于延长工作寿命的政策措施，工作条件有利和不利的劳动者在退出前后的健康轨迹随时间推移差异越来越大。
阿姆斯特丹纵向老龄化研究包括1992/1993年、2002/2003年和2012/2013年的基线样本，每个样本有两个为期3年的随访期。选定的受访者年龄在55岁及以上，他们在第一个或第二个3年间隔内辞去了有薪工作，最高至法定退休年龄（N = 522）。使用广义估计方程对退出前后的轨迹进行建模，结果变量为自评健康和身体限制，决定因素为身体需求、心理社会需求和心理社会资源。
平均工作退出年龄从20世纪90年代的60.7岁上升到21世纪10年代的62.9岁。平均而言，自评健康在连续各期有所下降，且退出前后无变化；平均身体限制在连续各期以及退出前后均大幅增加。我们的假设未得到支持。然而，无论工作暴露情况如何，我们发现21世纪10年代退出前后身体限制急剧增加。
尽管这些发现不支持我们基于工作暴露随时间推移健康轨迹不同的假设，但它们表明在较高年龄退出与退出前后较差的健康状况以及退出前后身体限制增加有关，这表明在不久的将来医疗保健成本会更高。
