Epidemiology Unit ASL TO3, Grugliasco, (TO), Italy.
European Commission, Joint Research Centre (JRC), Ispra, Italy.
Soc Sci Med. 2024 Aug;354:117084. doi: 10.1016/j.socscimed.2024.117084. Epub 2024 Jun 29.
In recent decades, pension reforms have been implemented to address the financial sustainability of social security systems, resulting in an increase in the retirement age. This adjustment has led to ongoing debates about the relationship between retirement and health. This study investigates the impact of time spent in retirement on the risk of cardiovascular disease (CVD) in Italy. It uses a comprehensive dataset that includes socioeconomic, health, and behavioural risk factors, which is linked to administrative hospitalisation and mortality registers. To address the potential endogeneity of retirement, we employ an instrumental variables approach embedded in a Poisson rate model. The results show that, on average, years spent in retirement have a beneficial effect on the risk of CVD for both men and women. Each additional year spent in retirement reduces the incidence of such diseases by about 17% for men and 29% for women. Stratified analyses and robustness tests show that the benefits of retirement appear to be more robust and pronounced in men and in certain groups, particularly men in manual occupations or with poor ergonomic conditions at work. These results highlight that delaying access to retirement may lead to an increased burden of CVD in the older population. In addition, the protective effect of retirement on the development of CVD among workers with poorer ergonomic conditions underlines the different impact of increasing the retirement age on different categories of workers and the need for targeted and differentiated policies to avoid hitting the more vulnerable.
近几十年来，养老金改革旨在解决社会保障体系的财务可持续性问题，这导致了退休年龄的提高。这一调整引发了关于退休和健康之间关系的持续争论。本研究调查了意大利退休时间对心血管疾病（CVD）风险的影响。它使用了一个综合数据集，其中包括社会经济、健康和行为风险因素，并与行政住院和死亡率登记处相关联。为了解决退休的潜在内生性问题，我们采用了一种嵌入泊松率模型的工具变量方法。结果表明，平均而言，退休时间对男性和女性的 CVD 风险都有有益的影响。每多退休一年，男性 CVD 发病率降低约 17%，女性降低约 29%。分层分析和稳健性检验表明，退休的好处在男性和某些群体中似乎更为稳健和显著，特别是从事体力劳动或工作时人体工程学条件较差的男性。这些结果表明，延迟退休可能会导致老年人口 CVD 负担增加。此外，退休对工作中人体工程学条件较差的工人 CVD 发展的保护作用突显了提高退休年龄对不同类别的工人的不同影响，以及需要有针对性和差异化的政策来避免打击更脆弱的群体。
