Fast track — ArticlesSelf-rated health before and after retirement in France (GAZEL): a cohort study
Introduction
Because of increasingly ageing populations, governments in most developed countries are seeking to increase the proportion of the population in work by raising the age of retirement.1, 2 However, reversing the downward trend in retirement age2, 3, 4 in this way is likely to be difficult,5 especially if older workers have suboptimum health at work4 while looking forward to a fairly healthy life after retirement.
Little is known about the effect of work and retirement on older workers' perceptions of health, which are a strong predictor of morbidity and mortality6, 7, 8 and of early retirement.9 Previous studies have produced conflicting findings, some suggesting that health improves after retirement,10, 11, 12, 13 others that it deteriorates,14, 15, 16 and some that it is not affected.17, 18, 19, 20 However, no evidence has been published for changes in health measured repeatedly over an extended period covering both several years of employment before and several years after retirement.
In this prospective study, we used yearly measurements of self-rated health in a large and varied French occupational cohort to examine trajectories of health from 7 years before retirement to 7 years after. We aimed to establish how people's perceived health is affected when they retire from work.
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Study population
The GAZEL cohort was established in 1989 and comprises employees of the French national gas and electricity company, Electricité de France-Gaz de France (EDF-GDF), from which the name of the study is derived.21 At baseline, 20 624 employees (15 010 [73%] men), aged 35–50 years, gave written consent to participate (figure 1). EDF-GDF employees hold civil-servant-like status that entails job security and opportunities for occupational mobility. Typically, employees are taken on when they are in
Results
Most of the 14 714 respondents were men, were married, and, during the observation period, belonged to high or intermediate employment grades because of promotion within the company (table 1). Of the respondents, 10 564 (72%) retired before 56 years of age and 14 635 (99%) before 61 years. 610 (4%) respondents retired for health reasons (early retirees). During the 3 years before retirement, 11% had depression, 29% musculoskeletal complaints, 15% physical illness, and 32% more than 21 days of
Discussion
In this large, French, occupational cohort, retirement was associated with a substantial decrease in prevalence of suboptimum health, corresponding to an 8–10 year gain in perceived health. This pattern was remarkably consistent across occupational grades and sex, and, although the effect was stronger for people who had had a poor work environment or health problems before retirement, we also recorded a significant improvement in other groups, apart from those with ideal working conditions.
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