Older health and social care workers’ labour market patterns: a 16-year longitudinal study from ages 61–65 to 76–80

Despite the large number of older workers in the health and social care sector, longitudinal, large-scale studies of their labour market situation are lacking. The aim of this study was to examine labour market patterns among older women and men working in the health and social care sector. A longitudinal cohort study of the 15,145 women and 6,059 men who, in 2010, were aged 66–70, in paid work at organisations classified as delivering health and social care services and had lived in Sweden throughout 2005–2010. Individually linked register data were used to analyse labour market states across 2005–2020 with sequence- and cluster analyses. Pronounced sex differences were observed in the occupational distribution at baseline (2010): the largest differences concerned assistant nurses and care assistants (46% of women, 21% of men) and physicians (4% of women, 25% of men). Income data indicated that many worked part-time at some point (5%-51% depending on the year). Women consistently earned less than men, both at baseline (median annual work income 8,199 vs. 10,213 EUR) and throughout the study period. Three distinct clusters of labour market sequences were identified among women and four among men. These clusters differed from each other in timing of work exit, history of sickness absence and disability pension, occupations, and type of care settings. Patterns representing extended working lives were relatively common (51% of all women and 60% of all men) but less common among workers in residential care, as well as among assistant nurses and care assistants, regardless of sex. The findings highlight the sex segregation of occupations and the income gap in the Swedish labour market and show that extended working lives were less common in certain occupations and care settings. Stakeholders should consider these differences when designing policies aimed at encouraging extended working lives and ensure that women and men have equal opportunities to remain in paid work.