A Study of Longitudinal Trajectories of Health and Job Demand on Retirement Age

Abstract

In this paper, we characterized health trajectories over an 18-year period for a cohort of American workers.  We used administrative data to track monthly, health-related events for six chronic diseases (asthma, arthritis, diabetes, depression, ischemic heart disease, and hypertension) including the diagnoses of new disease, hospitalizations, and outpatient visits.  Using these data, we first used sequence and cluster analysis to characterize long-term trajectories of health and to group workers according to their patterns of work experience.  We then modeled the relationship of these health trajectories to retirement age, accounting for baseline underlying health, as well as a number of demographic and job-related characteristics.  Finally, we consider the role of physical and psychosocial job demand in retirement age.

Our analysis produces a number of findings that should be of interest to those studying retirement policy.  In our data, workers can be categorized into a small number of distinct work trajectories.  While the majority of workers in this sample remain relatively healthy for much of the observation window, others exhibit patterns of health-related events that are often marked by hypertension and/or arthritis.  We find that clusters characterized with health events related to hypertension and arthritis are likely to retire later, not earlier.  We offer a possible interpretation that these numerous health-related events are signaling the proper management of these chronic diseases, allowing workers to extend their working life.  Moreover, we find an association with job demands and retirement, even after controlling for health.  Specifically, we find that increases in exposure to heat are associated with lower retirement age, as is less decision-making autonomy.  The limitations of this paper include the lack of a representative sample, a relatively small sample size, and the strong incentives of retirement pensions in this cohort that may overwhelm other factors related to retirement decisions.

The paper found that:

• There are six distinct clusters of health trajectories, which are largely characterized by diagnosis and management of hypertension and arthritis.
• Workers with health trajectories that involve more health-related events, and in particular hypertension, were actually more likely to retire later relative to their healthier peers. This may reflect better management of hypertension through more frequent outpatient physician visits, or a greater need for health insurance coverage.
• Increases in one physical job demand—heat —and decreases in one psychosocial job demand —decision-making autonomy—were associated with lower retirement age.

The policy implications of the findings are:

• Interventions to decrease the prevalence of, or help in the management of, hypertension and arthritis may help keep workers healthier while working.
• Retirement pensions and health insurance provide strong incentives for employees to work longer.
• Lessening demanding job conditions, and in particular exposure to heat, could allow workers to retire later. Likewise, creating opportunities in the workplace for workers to have greater decision-making autonomy may also incentivize later retirement.