An article published Online First and in a future edition of The Lancet reports the findings of the GAZEL study. It shows that in terms of perceived health problems, ill-health is improved by retirement for all groups of workers, except those with ideal working conditions. Therefore, in order to encourage older workers to remain in the workforce, working conditions must be improved.The article is the work of Dr Hugo Westerlund, Stress Research Institute, Stockholm University, Sweden, and University College London, UK, and colleagues.

A total of 14,714 employees from the French national gas and electricity company self-rated their health during the GAZEL cohort. The records were taken seven years before and seven years after retirement, with yearly measurements from 1989 to 2007. A total of 11,581 were men (79 percent). The authors examined the data and found that in general, suboptimum health increased with age. However, between the year before retirement and the year after, the estimated prevalence of suboptimum health fell from 19 percent to14 percent. This corresponds to a gain in health of 8 to10 years. In other words, in terms of the risk of suboptimal health, people suddenly got 8 to10 years younger when they retired. This retirement-related improvement existed in both men and women, and across occupational grades. Also, it was maintained throughout the seven years after retirement. A poor work environment and health complaints before retirement were associated with a steeper yearly increase in the prevalence of suboptimum health while still in work, and a greater retirement-related improvement. However, people with a combination of high occupational grade, low demands, and high satisfaction at work showed no such retirement-related improvement. The authors observe that this ‘ideal’ combination of circumstances only applied to around 2 percent of workers.

The authors explain that their research indicates that work puts an extra burden on health when it is highly demanding and not satisfying. However, the effects of this burden are reversible. The results also show that marital status did not affect the association between retirement and suboptimum health. This probably indicates that the retirement-related improvement was more related to work than to private life.

In this study, the records used are from employees in a company operating throughout France, both in rural and urban areas, including a wide range of occupations. But compared with many employees worldwide, the participants retired much more early (as early as age 55 years). In addition they benefited from good social security, receiving 80 percent of their former salary in pension. However, the substantial improvements recorded in most of the employees suggest that the observed results could be quite possibly generalised to other settings with generous social security after retirement and to a large proportion of employees in developed countries.

The authors explain: “Our findings should cause concern for policy makers attempting to convince workers to stay longer in the workforce. Older workers who have deteriorating perceived health, and who might additionally be aware that many of their slightly older friends and former colleagues enjoy excellent health since they retired, might feel more motivated to retire early than to continue working beyond statutory retirement age.”

They write in conclusion: “If our findings apply in settings in which social security is less comprehensive than for participants in the GAZEL cohort study, financial incentive might not be enough – and not the most ethical way – to counteract the drift towards an earlier retirement age. Arguably the best option is to redesign working life for older workers to make it healthier and more satisfying than at present, and thus, hopefully, achieve improved occupational health and quality of life, increased productivity, and a larger proportion of the population in work.”

In an associated comment, Dr Johannes Siegrist and Dr Morten Wahrendorf, University of Düsseldorf, Germany, remark: “The policy implications of Westerlund and colleagues’ study are fairly convincing. If poor quality of work reduces health and wellbeing of aged workers and reduces the participation of this age-group in the labour force, efforts need to be directed towards improving healthy work at the level of single organisations and companies, and at the level of national labour and social policies.”

“Self-rated health before and after retirement in France (GAZEL): a cohort study”
Hugo Westerlund, Mika Kivimäki, Archana Singh-Manoux, Maria Melchior, Jane E Ferrie, Jaana Pentti, Markus Jokela, Constanze Leineweber, Marcel Goldberg, Marie Zins, Jussi Vahtera
DOI: 10.1016/S0140-6736(09)61570-1
The Lancet

Written by Stephanie Brunner (B.A.)