Older Health and Social Care Workers’ Labour Market Patterns over 16 Years: from Ages 61–65 to 76–80

Abstract Background Despite the high number of older workers in the health and social care sector, there is a lack of longitudinal, large-scale studies investigating labour market pathways in this group. Our aim was to examine labour market patterns among older women and men in the health and social care sector. Methods A longitudinal cohort study of the 15,145 women and 6,059 men who, in 2010, were aged 66-70, worked at organisations classified as delivering health and social care services, and had lived in Sweden in 2005-2010. Individually linked register data were used to analyse labour market states across 2005-2020 with sequence- and cluster analyses. Results Pronounced sex differences were observed in the distribution of occupations at baseline in 2010: the largest differences were observed regarding assistant nurses (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 during the study period (proportion varied between 5% and 51% depending on the year). Women earned consistently less than men, both at baseline (median annual work income 8,199 EUR vs. 10,213 EUR) and throughout the study period. We identified three distinct clusters of labour market sequences among women and four distinct clusters among men. These clusters differed from each other in timing of work exit, history of sickness absence and disability pension, and in the distribution of educational level, partnership status, occupations and type of care settings. Conclusions Many health and social care workers remained in paid work after ages 66-70, at least to some degree. Large sex differences were observed in occupations at baseline and in earnings. Labour market patterns characterized by prolonged working lives seemed to be more common in certain occupations and in certain care settings, pointing to structural and contextual factors shaping later-life labour market participation. Key messages • This large, longitudinal cohort study found substantial sex differences in income among older health and social care workers and showed that contextual factors shape later life work participation. • Public health policies should ensure equal pay for equal work and improve working conditions to attract and support older workers to prolong their working life in the health and social care sector.