By Ben Lennox Kail, Ph.D.
For many people in the United States, retirement represents a major life-course transition. Although many life transitions are empirically linked to changes in health—and many iterations of life course theory suggest that retirement should be related to changes in health—the empirical research on the association between retirement and health is equivocal. There is some evidence that retirement is good for health, some evidence that retirement is bad for health, and some evidence that retirement has no relationship with health at all. This conflicting evidence means that the association between retirement and health is generally unclear.
Retirement can take many forms, creating multiple retirement transitions or scenarios, thus clouding the association between retirement and health. For instance, although it has grown less common than it was in the past, some people make a clean break from full-time employment to full retirement as soon as they become eligible for private pensions, Social Security, and/or Medicare. Others may shift from full-time work to part-time work months or years before fully retiring. Additionally, people have access to different types of resources before and after retirement. These resources likely play an important role in putting the retirement transition into perspective while showing how it relates to health.
One resource I thought would be particularly important in contextualizing the retirement transition—especially when that transition occurs before Medicare eligibility—was private insurance coverage. In a recent article published in the Journal of Gerontology: Social Sciences, I asked whether the association between retirement and health would differ depending on access to employment-based insurance coverage before and after retirement.
To address this research question, I used the 1996–2010 Waves of the Health and Retirement Study data. To measure retirement, I compared people who went from full-time work to retirement with people who were engaged in full-time work in two consecutive waves. Both groups were between the ages of 50 and 64. I also examined four patterns of insurance coverage:
- Steady insurance (employment-based insurance in two consecutive waves)
- No employment-based insurance (no employment-based insurance in two consecutive waves)
- Lost insurance (had employment based insurance in the first wave but not in the second wave)
- Gained insurance (no employment-based insurance in the first wave, but had it in the second wave)
I assessed the associations of insurance and retirement (as well as their interactions) on three health outcomes:
- Symptoms of depression
- Activities of daily living limitations (ADLs)
- Instrumental activities of daily living limitations (IADLs), net of demographic and economic characteristics, as well as prior levels of health
Finally, because people’s retirement decisions and employment-based insurance coverage may be contingent upon prior health, I relied on a series of two-stage models to account for potential endogeneity among health, retirement, and insurance coverage.
Retirement, Patterns of Private Insurance, and Depressive Symptoms
There were several key findings to this study. First, after adjusting for demographic and economic characteristics, as well as prior health and endogeneity between prior health and the retirement transition, the transition to retirement was associated with greater symptoms of depression, ADLs, and IADLs. Second, relative to having steady insurance, being without employment-based insurance in consecutive waves was associated with higher levels of depressive symptoms (but not ADLs or IADLs), and losing employment-based insurance was associated with higher levels of depressive symptoms and ADLs (but not IADLs).
Finally, the association between retirement and health was exacerbated among those who either were without insurance in consecutive waves or lost insurance between waves, meaning people who lost insurance and retired experienced more symptoms of depression, ADLs, and IADLs than those who retired with steady employment-based insurance. Similarly, people who were without insurance in consecutive waves experienced more symptoms of depression and ADLs (but not IADLs) than those who retired with steady employment-based insurance. This suggests that access to employment-based insurance is an important contextual factor in the association between the retirement transition and subsequent health.
These findings not only make empirical contributions to the relationship between retirement and health, they also help shed some light on the ambiguity of the relationship between retirement and health. It is not simply important whether someone retires, it is important how someone retires and the resources they can access before and after retirement. I hope we see more research on the contextual factors surrounding the retirement transition and how these factors help shape how people adjust to retirement—both regarding their health and in other ways as well.
References
Kail, B. L. (2016). The Mental and Physical Health Consequences of Changes in Private Insurance Before and After Early Retirement. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 71(2), 358-368. doi: 10.1093/geronb/gbv020
About the Author
Ben Lennox Kail, Ph.D., is an assistant professor of sociology at Georgia State University in Atlanta, as well as an affiliate faculty member of the Gerontology Institute. He completed his doctorate in sociology at Florida State University in 2010, and for 2 years was the recipient of an NIH-funded postdoctoral fellowship on the social, medical, and economic demography of aging at Duke University. His research focuses on the areas of social gerontology, productive engagement (particularly work, volunteering, and caregiving), public policy (particularly insurance and welfare), and health (particularly disability and chronic conditions). He can be reached via email (bkail@gsu.edu) or through his GSU faculty webpage.
IMAGE COPYRIGHT: Shutterstock/zimmytws
