Lallukka Tea, Kolmonen Petteri, Rahkonen Ossi, Lahelma Eero, Lahti Jouni
Department of Public Health, University of Helsinki, Helsinki, Finland.
LUT School of Engineering Sciences, LUT University, Lappeenranta, Finland.
PLoS One. 2025 Jan 29;20(1):e0317010. doi: 10.1371/journal.pone.0317010. eCollection 2025.
Health behaviors, health, and income change during aging. However, no previous studies have examined, how they develop together over the transition to statutory retirement. We aimed to examine their joint development and to identify the determinants of any distinct trajectories.
We studied former employees of the City of Helsinki, Finland, who transitioned to full statutory retirement between 2000 and 2022 (n = 5209, 80% women). We examined five repeated questionnaire surveys to identify any joint developmental patterns in the key indicators of healthy aging and well-being-leisure-time physical activity, health measured by general health perceptions, and household income, over a follow-up of 22 years. We used joint group-based trajectory analysis to identify latent developmental groups. The social and health-related determinants of trajectory group membership are reported as average marginal effects.
We found four distinct joint trajectory groups. Group 1 (22.6%) had consistently poor general health perceptions, less physical activity than the recommended amount, and low income. In Group 2 (34.2%), general health perceptions were first good but then declined, and income was low but slightly increasing. Group 3 (12.3%) had good general health perceptions, a very high level of physical activity, but fluctuating income. In Group 4 (30.9%), general health perceptions were first good but then declined, physical activity was at the recommended level, and income was sharply increasing. People with obesity had a 22 percentage-point (21-24) higher predicted probability of belonging to Group 1 than people with normal weight. They were also more likely to report low education and more physician-diagnosed chronic diseases and mental disorders.
We identified distinct trajectories in physical activity, general health perceptions, and income over a follow-up of over 20 years. The majority of those who had transitioned to statutory retirement had good general health perceptions but varying levels of physical activity and income. As not all those with a low income had a low level of physical activity or poor general health perceptions, public health interventions should target distinct groups with the most adverse risk factor profiles, to narrow health inequalities during aging.
健康行为、健康状况和收入在衰老过程中会发生变化。然而，以前没有研究考察过它们在向法定退休过渡期间是如何共同发展的。我们旨在研究它们的共同发展，并确定任何不同轨迹的决定因素。
我们研究了芬兰赫尔辛基市的前雇员，他们在2000年至2022年期间过渡到完全法定退休（n = 5209，80%为女性）。我们检查了五次重复的问卷调查，以确定在22年的随访中，健康老龄化和幸福感的关键指标——休闲时间身体活动、通过总体健康感知衡量的健康状况和家庭收入——的任何共同发展模式。我们使用基于群体的联合轨迹分析来识别潜在的发展群体。轨迹组成员的社会和健康相关决定因素以平均边际效应报告。
我们发现了四个不同的联合轨迹组。第1组（22.6%）的总体健康感知一直较差，身体活动低于推荐量，收入较低。在第2组（34.2%）中，总体健康感知最初良好，但随后下降，收入较低但略有增加。第3组（12.3%）的总体健康感知良好，身体活动水平非常高，但收入波动。在第4组（30.9%）中，总体健康感知最初良好但随后下降，身体活动达到推荐水平，收入急剧增加。肥胖者属于第1组的预测概率比正常体重者高22个百分点（21 - 24）。他们也更有可能报告教育程度低以及更多医生诊断的慢性病和精神障碍。
我们在20多年的随访中确定了身体活动、总体健康感知和收入的不同轨迹。大多数过渡到法定退休的人总体健康感知良好，但身体活动水平和收入各不相同。由于并非所有低收入者的身体活动水平都低或总体健康感知差，公共卫生干预应针对具有最不利风险因素特征的不同群体，以缩小老龄化过程中的健康不平等。
