LATE CAREER TRANSITIONS: RETIREMENT AND WELL-BEING

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LATE CAREER TRANSITIONS: RETIREMENT AND WELL-BEING Marianna Virtanen Research Professor Academy of Finland Research Fellow marianna.virtanen@ttl.fi

Theoretical perspectives to retirement transition Role theory: retirement is a role transition (Moen et al., 1992, Riley & Riley, 1994) Transition from employment to retirement includes work role loss but strengthening of the family member role and the community member role Anxiety and depression may increase if the work-related roles had been particularly important in maintaining one s identity and positive self-image If the job has been stressful, transition to retirement could be a positive experience Continuity theory: retirement is an opportunity to maintain social relationship and lifestyle patterns (Atchley, 1989) Suggests no significant decrease in well-being in transition from work to retirement if people can maintain their general patterns; familiar strategies in familiar arenas of life Wang, 2007

Life course perspective: There are crucial concepts to be understood in postretirement well-being (Elder, 1995) 1. Transitions and trajectories; retirement is a process that incorporates both the retirement transition and post-retirement trajectory -> They can be interdependent 2. Contextual embeddeness; the experience of life transitions and developmental trajectories is contingent on the specific circumstances under which the transition occurs 3. Interdependence of life spheres; the experience in one life sphere influence and is influenced by experiences in other life spheres 4. Timing of transitions; whether the transition timing is normative or not Wang, 2007

Psychological well-being Psychological well-being change patterns during the retirement transitions (a) Role theory (b) Continuity theory (c) Life course perspective Maintaining pattern (b) Recovering pattern (a) U-shape pattern (c) Reducing pattern (a) Time Modified from Wang, 2007

Outline Question: Do work-related and non-work related psychosocial factors predict timing of transition from work to retirement and health and well-being after the transition? Part I presents results on predictors of continuing employment beyond the pensionable age among elderly employees Part II presents results from a 21-year follow-up study on the association of midlife predictors of post-retirement depression Part III presents findings on the health effects of transition from work to retirement

Plos One 2014;9(2):e88695 In the Finnish Public Sector Study, employees who reached statutory pensionable age between 2005-11 (N=4677, mean age 59.8 in 2005) were selected. Outcome was voluntary extension of employment >6 months after the individual pensionable date; data based on the records of the Municipal Pension Institute (Keva). Those with work disability pension were excluded Socio-demographic, health and work-related factors approximately 3.7 years before the statutory pensionable age were collected from surveys and registers Multivariable adjusted binary logistic regression models were used to examine predictors of extended employment

Voluntary extension of employment in the Finnish Public Sector Study -> The strongest predictor was opportunity to control work time Virtanen M, Oksanen T, Batty GD, et al., Plos One 2014

Good work time control enhanced longer employment among employees with psychological symptoms Virtanen, Oksanen, Batty et al., Plos One 2014

Am J Geriatr Psychiatry 2014 3 941 Whitehall II Study participants from UK (2 790 men, 1 151 women) All participants were retired at follow-up (mean age 67.6 years at follow-up Midlife socioeconomic and psychosocial adversity was assessed by survey questionnaires 21 years earlier (at the study baseline) when the participants were still employed: Low occupational position, poor standard of living, high job strain, few close relationships

Yhteenveto Methods Occupational position: 3 grades (low intermediate high); in the Whitehall study it is a comprehensive marker of socioeconomic position and is related to salary, social status and level of responsibility at work Standard of living was assessed with a question: "All things considered, how satisfied or dissatisfied are you with your standard of living? (1= very dissatisfied to 7=very satisfied) -> A 3-category variable was formulated to indicate poor (1-2), moderate (3-5), and good (6-7) Job strain; a combination of job demands and job control (low strain active passive high strain) job Number of close people was requested by asking the participant to report the number of people they feel very close to (including people who have died and people they have not seen recently); 3 categories: 0-2, 3-6, and 7 or more close people

Yhteenveto Methods Depression: the 20-item CES-D scale was at 16 years (2002-4) and 21 years (2007-9) after the assessment of the baseline exposures Psychological symptoms at baseline and during followup surveys were assessed by the GHQ-30 Covariates: sex, length of follow-up (years), and from the 2002-4/2007-9 examinations; age, marital status, income, self-reported longstanding illness, clinically verified coronary heart disease, smoking, alcohol use and physical functioning (SF-36 physical function score)

Proportion of participants with postretirement depression by midlife adversities Onset (%) Onset of post-retirement depression Overall onset 13.6% high int. low good int. poor low act. pass. high 7+ 3-6 0-2 Virtanen et al., 2014

Likelihood of post-retirement depression by midlife adversities Adjusted risk* OR of post-retirement depression 2.24 (1.57-3.19) 1.70 (1.15-2.52) 1.16 (0.88-1.52) 1.50 (1.19-1.89) 1.52 (1.09-2.14) 1.00 1.00 1.00 0.94 1.00 (0.69-1.29) 1.55 (1.16-2.09) 1.27 (1.00-1.63) high int. low good int. poor low act. pass. high 7+ 3-6 0-2 *Adjusted for age, sex, length of follow-up time, occupational position, psychological distress at baseline and during follow-up; follow-up marital status, long-standing illness, coronary heart disease, smoking, alcohol use, physical function and income. Virtanen et al., 2014

Likelihood of post-retirement depression by the number of midlife adversities Adjusted risk* OR of post-retirement depression 2.91 (1.29-6.56) 2.94 (1.58-5.47) 2.49 (1.80-3.43) 2.26 (1.21-4.22) 1.34 (1.06-1.69) 1.73 (1.33-2.25) 1.48 (1.16-1.89) 1.31 (1.03-1.67) 1.00 1.00 1.00 1.00 1.00 0 1 2-4 0 1 2 0 1 2 0 1 2 *Adjusted for age, sex, length of follow-up time, occupational position, psychological distress at baseline and during follow-up; follow-up marital status, long-standing illness, coronary heart disease, smoking, alcohol use, physical function and income; socioeconomic and psychosocial adversities adjusted for each other and work related and non-work related adversities adjusted for each other Virtanen et al., 2014

Continuity of psychological symptoms in midlife and post-retirement Virtanen et al., 2014

7138 employees (76% women) from the Finnish Public Sector Study who retired at statutory retirement age between 1995 and 2004 Date of retirement was obtained from the Finnish Centre of Pensions Data on purchases of antidepressants (>=30 days dose) 4 years before and 4 years after retirement were obtained from the Social Insurance Institution

Trajectories of antidepressant and diabetes medication use in relation to retirement Oksanen et al. 2011

BMJ 2010:341:c6149 14 104 participants (80% men) in the French GAZEL cohort Yearly measures of psychosocial factors, health and well-being 7 years before and 7 years after retirement Trajectories of respiratory disease, diabetes, cardiovascular diseases, mental fatigue, physical fatigue and depression were examined in relation to retirement

Trajectories of health in relation to retirement Westerlund et al., 2010

Effect of transition in employees with high-risk and low-risk profiles Westerlund et al., Lancet 2009

Yhteenveto Conclusions Psychosocial working conditions have an effect on several aspects of the transition process from work to retirement Voluntarily postponing the timing of retirement -> leading to longer work careers Health and well-being after transition The presented studies give support to recovering pattern and maintaining pattern in transition in relation well-being after retirement Those with recovering pattern seem to have higher level of symptoms despite the recovery than those with maintaining pattern Psychosocial and socioeconomic adversity in midlife may have predictive value to depression postretirement

Thank You! 22