Socio-Economic Differences in Health Trajectories Around Retirement in the USA

There is increasing concern about possible widening inequalities in health amongst the older population. There is a growing body of work on the relationships between patterns of labour market participation in later life and health. However the results are equivocal and little has been done to explore socio-economic variations in the impact of retirement on health. To redress this data from 10 waves of the Health and Retirement study in the USA were used to analyse trajectories of poor health and retirement for different socio-economic groups. Repeated-measures logistic regression with generalised estimating equations were used to analyse data up to 7 years before and 7 years after retirement from 1992 to 2010. The results show that for the sample as a whole the prevalence of sub-optimal health increases sharply in the years before retirement, from around 16% four years before retirement to 23% at retirement. Following retirement the prevalence of poor health remains high but the rate of increase slows down. Educational differences are evident throughout the period. Those with a lower levels of education have higher rates of poor health for all years and show a more rapid increase in poor health up to and beyond  retirement compared to those with higher levels of education. Four years before retirement 25% (95% CI 20.0-30.0) of those with a lower education reported poor health compared to 12% (95% CI 9.8-14.1)of those with a higher education. At retirement this had risen to 36 % (95% CI 31.5-41.2) and 19% (95% CI 16.7-21.3) respectively. The analyses suggest that poor health is a main driver of retirement in the USA. Also those with lower levels of education continue to be at greater risk of poor health following retirement which might contribute to growing health inequalities in later life.