Associations of sociodemographic, health, and work-related factors with early long-term economic inactivity in older workers: Findings from the Health and Employment After Fifty study

Objectives To explore determinants of early long-term economic inactivity (ELTEI) among older workers in England. Methods We analysed data from the Health and Employment After Fifty (HEAF) study, which prospectively followed a population-based sample of individuals in England who were aged 50−64 years at recruitment in 2013−14. ELTEI was defined as being out of paid work continuously for 12 months or longer before state pension age. Risk factors for first onset of ELTEI were examined by discrete-time Cox regression, taking as time intervals the periods between successive annual questionnaires. Associations were summarised by hazard ratios (HRs). Results During follow-up of 3,450 participants for up to five years (a total of 11,561 12-month intervals), 682 (19.8%) entered ELTEI. In adjusted models, the strongest risk factors reflected financial security: low contribution to family income (HR 2.06, 95%CI 1.30, 3.25 men; 1.66 95%CI 1.25, 2.19 women), expectation of receiving a private/employer pension (HR 2.14, 95%CI 1.27, 3.77 men), anticipated high retirement income (HR 2.27, 95%CI 1.50, 3.44 men; 1.39 95%CI 1.04, 1.85 women) and having no mortgage or rent commitment (HR 1.75, 95%CI 1.09, 2.83 men; 1.62 95%CI 1.02, 2.56 women). Job dissatisfaction (HR 1.83, 95%CI 1.24, 2.64 men; 1.40 95%CI 0.99, 1.99 women) was associated with increased risk, as was absence of high physical work demands, especially among women (HR 0.68, 95%CI 0.48, 0.97 women). The only significant health-related risk factor was report of slow walking speed (HR 3.17, 95%CI 1.84, 5.33 men; 1.77 95%CI 1.18, 2.69 women). Conclusions In contrast to high annual sickness absence, ELTEI is more common among individuals with higher education and less physically demanding jobs and seems to be driven largely by considerations of personal finance and affordability.