Workpackages

Objectives To determine the impact of legislation and policy measures that have increased retirement ages  across European countries in the past two decades on different pathways to retirement among  workers with pre-existing health problems. Description of work Data from the European Union Statistics on Income and Living Conditions (EU-SILC) are used to analyse how legislation and policy measures to increase statutory retirement age have influenced the pathways towards retirement among workers with pre-existing health problems. First, a comparative analysis across European countries will be conducted on how legislation and policies (such as employment protection, income support, and disability and pension benefits) have influenced labour market exit through competing exit routes (unemployment, disability benefit, early retirement, economically inactivity). A novel approach is to enrich these datasets with key indicators of legislation and polices from the OECD (employment protection level, active labour market policies) and economic indicators (labour force participation, gross domestic product). Second, detailed national statistics with repeated cross-sectional data on employment status per age, gender, educational level and type of work in United Kingdom, Netherlands, and Sweden will be used to determine the impact of legislation and policy changes in specific periods for their effects on retirement age among older workers. These analyses will also address how these legislation and policy changes have influenced exit through disability and unemployment as indirect precursors or competing routes for early retirement. Novel econometric techniques will be used, specifically differences-in-differences method and regression discontinuity, as these techniques have shown promising outcomes in earlier policy evaluations.
Objectives To estimate the long-term impact of workplace and lifestyle interventions and polices to prolong employment trajectories for workers with chronic health conditions Description of work Several longitudinal studies across European countries will be used to determine how interventions on specific work-related risk factors and lifestyle behaviours influence working life among European citizens. Previous studies points towards lack of job control and low rewards as crucial work-related factors for quitting paid employment prematurely. Obesity, lack pf physical activity, and excessive alcohol intake are key health behaviours. The relative importance of these risk factors for early retirement and other routes is determined by Population Attributable Fractions. Subsequently, workplace interventions, health interventions and legislation and policy measures will be modelled through potential impact fractions of these interventions on loss of paid employment. A Health Impact Assessment (HIA) model will be constructed, using a multistate Markov model with (i) annual probabilities of early retirement by age, gender, and education, (ii) subsequent marginal probabilities that a person is employed or retired, and (iii) proportion of transition due to established risk factors (PAF) and policy measures (WP1). This HIA model will estimate Working Life Expectancy (WLE) as expectancy measure related to different policies and Working Years Lost (WYL) as gap measure due to strenuous work and unhealthy lifestyle. The Population Impact Fraction will predict the proportion of WLE that can be prevented by workplace and lifestyle interventions, thereby prolonging working life. A toolbox in a commonly available software package, e.g., open source spreadsheet, will be developed that allow stakeholders to calculate WLE and WYL for particular interventions and policy measures in specific target populations.
Objectives To examine the impact of legislation and policy measures on worker’s health in different social groups before and after retirement Description of work Data from Understanding Society from the UK will be used to investigate the effect of the policy to postpone retirement age from 60 to 65 on health among women. In this study, mental and physical health (SF12) as well as psychological status (GHQ-12) are measured among women aged 60-64 years in six waves between 2009 and 2015. In addition, information about employment status and job type as well as biomarkers is available. Job-type health inequalities and higher state pension age will be investigated. These analyses will provide crucial information as to whether the current push towards a higher statutory retirement age for every worker could influence health inequalities.
Objectives To examine the impact of legislation and policy measures on worker’s health in different social groups before and after retirement, specifically in Swedish cohort with over 40 years follow-up. Description of work This WP further studies in depth the objective of WP3 by having additional information on voluntary retirement packages as well as detailed (time-varying) information on morbidity and mortality. A unique dynamic cohort of 389,000 construction workers who enrolled during a health examination between 1971-1992 will be used with information on health (height, weight, spirometry, hemaglobin, blood pressure), smoking habits, and job characteristics at time of enrolment. The cohort data is enriched through linkage with Hospital Discharge register, Cancer register, and Death register, providing date of diagnosis of morbidity and mortality. Linkage is also done with disability pension register and a register on industry and sources of income (LISA Statistics Sweden). The impact of changes in retirement (1976: from 67 to 65 yrs; 2003: from 65 to 67 yrs; 1999: voluntary retirement package) on morbidity and mortality after retirement will be determined in a period-cohort model with Poisson regression analysis. The drastic reform with limited eligibility for disability benefits in 2008 will be studied through difference-in-difference method for spill-over effects into other exit routes of paid employment before statutory retirement age and their effects on morbidity and mortality after statutory retirement age.
Objectives To conduct a cost-effectiveness analysis as well as a cost-benefit analysis on interventions and legislation and policy measures for a sustainable and inclusive workforce. Description of work The identified interventions and programmes at individual level on health promotion and workplace adaptations (WP2) and policies and provisions (WP1) will be evaluated for their cost-effectiveness. The cost-effectiveness analysis will compare the costs and health effects of interventions to assess the extent to which it can be regarded as providing value for money. Important outcomes will be costs for gains in quality-adjusted life years (QALY), improved work productivity (less sickness absence, increased productivity at work, increased work ability) and working years gained. The results of these analysis will be plotted in a cost-effectiveness plane, showing four-quadrants of interventions that are more effective and more expensive (I), those that are more effective and less expensive (II), those being less effective and less expensive (III), and those that are less effective and more expensive (IV). A comparative analysis will be conducted to evaluate whether all outcome measures present similar cost-effectiveness, and whether particular outcome measures are to be preferred for decision makers at different levels (e.g. societal versus company perspective, health care versus employment). In conjuncture, summary measures will be discussed with participating stakeholders, such as Return-on-Investment (RoI), in order to facilitate better knowledge dissemination.