Retirement Health Article

RETIREMENT

Aging is associated with an increased likelihood of major life transitions, such as onset of disease and disability and of widowhood. In contrast to these "unplanned" changes, retirement is a major transition that is often contemplated, anticipated, and planned for a number of years before the actual event. Retirement at the end of one's career has been described as "a fixture of the American social ethos and political economy" (Hayward et al.,1998). Much research has focused on the economic aspects of retirement, particularly income security, while other research has tried to describe and understand the potential negative impact of retirement on health and well-being.

Many reviews of the evidence have concluded that a negative impact on physical and mental health of retirees has not been demonstrated. This conclusion is based on convergent evidence showing an absence of an adverse impact, rather than confusing evidence that does not permit any broad generalizations.

Older studies tended to show neither adverse effects nor benefits associated with retirement. Some specific variables, such as subjective evaluations of the health of retirees, sometimes showed health improvement, but this was seen as a function of reinterpreting one's health in the absence of the physical demands of a job. More recent studies have tended to show some benefits of retirement, primarily in the psychological domain and in health behaviors. One longitudinal study did show modest adverse effects on blood pressure and serum cholesterol, but these were deemed clinically insignificant. Retirement could also lead to a higher propensity to seek care, which might be misinterpreted as more episodes of illness. A 1991 study of older steel workers who were forced to retire early because of downsizing did not show any adverse effects on their health. Thus, loss of a job close to normal retirement age may have only small negative effects.

In addition to the broad conclusion of no adverse impact on health and functioning, the following points can be made on the basis of accumulated evidence:

1. Variations in postretirement outcomes are most convincingly seen as reflecting a continuation of pre-retirement status, particularly in the areas of physical health, social and leisure activities, and general well-being and satisfaction.
2. Certain predictors of outcome, such as prior attitudes toward the process of retirement and expectations about post-retirement outcomes, appear to make their contribution primarily via their association with underlying variables, such as prior health status and financial aspects of retirement. Consequently, they do not indicate the differential impact of retirement but rather reflect, once again, a continuation of pre-retirement attitudes and status.
3. Variables reflecting aspects of a person's work role (e.g., job satisfaction, work commitment) do not appear to be powerful or consistent predictors of outcomes. This conclusion may be viewed as somewhat of a surprise, and it can be argued that the cumulative evidence on this point is not yet very compelling.

There is no question that poor health leads to "early" or "involuntary" retirement. This makes it difficult to test the proposition that planned ("on schedule") retirement does not have a negative impact, but unplanned and involuntary ("off schedule") retirement does. The difficulty is that the downward health-status trajectory that precipitated the retirement will manifest itself as poorer health status after retirement.

Those who choose to continue to work well beyond conventional retirement age are an unusual group, made up of people in good health and with a strong commitment to work. It is in this group that the effects of "mandatory" retirement need to be studied, not among blue-collar workers who usually prefer to retire early, and do so if retirement benefits are adequate. But, unfortunately, people in such occupational groups as doctors, judges, and farmers, who often continue working beyond normal retirement, are not easily recruited into a study of "mandatory" retirement.

Phyllis Moen, a sociologist, has argued that the relationship between retirement and health is a very complex one and that most designs do not capture this complexity. She has developed a life-course model that may lead to a more sophisticated research agenda for the future. In spite of this complexity, the accumulated evidence so far leads to the conclusion that no adverse effects of retirement have been documented.

STANSILAV KASL

BETH A. JONES

(SEE ALSO: AARP; Aging of Population; Behavior, Health-Related; Widowhood)