Country- and individual-level factors associated with healthy working life expectancy: A multinational longitudinal study
by Jingjie Zhu, Bo Ye, Zeyu Huang, Huazhen You, Junjia Jiang, Shitong Yang, Junling Gao Background To address labor force shortages associated with population aging, many countries have proposed raising the retirement age. As health is an important determinant of employment outcomes among older workers, it is important in this context to understand the individual- and country-level factors…
The study, led by Jingjie Zhu and colleagues, explored the various factors influencing healthy working life expectancy (HWLE) on a global scale. HWLE represents the years individuals can anticipate remaining healthy and employed from age 50. The multinational prospective cohort study analyzed data from six health and retirement cohorts, encompassing 79,833 men and 95,485 women, aged 50 and above, from 28 countries.
Individual-level factors such as demographics, socioeconomic status, lifestyle choices, and chronic diseases were evaluated. Country-level factors included economic indicators like GDP per capita, health expenditure, tax revenue, Gini index, and ease of doing business, as well as employment metrics, including flexible working arrangements, labor force participation, equal workforce opportunities, and hiring and firing practices.
Governance metrics such as effectiveness, corruption control, and political stability were also incorporated.
At the age of 50, the total life expectancy (TLE) was calculated at 33.59 years (95% CI [33.49, 33.69]), with 10.98 years (95% CI [10.87, 11.08]) constituting HWLE. The study found that women had shorter HWLE (9.82 years, 95% CI [9.68, 9.97]) compared to men (12.36 years, 95% CI [12.22, 12.50]). Marital status, higher education, and healthy lifestyles were positively correlated with longer HWLE, while chronic diseases, particularly stroke, led to a significant reduction of 5.49 years (95% CI [4.94, 6.04]) in HWLE.
On a country level, higher health expenditures, GDP per capita, and tax revenue contributed to increased HWLE. Greater governance effectiveness, corruption control, and ease of doing business also correlated with longer HWLE. Conversely, higher Gini index and political instability were associated with shorter HWLE. Additionally, countries with more flexible working arrangements, higher labor force participation, equal workforce opportunities, and more favorable hiring and firing practices experienced longer HWLE and nHWLE (number of healthy working life years), alongside shorter nHnWLE (number of healthy non-working life years).
The study acknowledges certain limitations, including variations in follow-up periods across cohorts, relatively small sample sizes in some countries, and incomplete global coverage, which may impact cross-country comparability and generalizability. The findings highlight the importance of implementing measures tailored to specific country contexts to extend healthy working lives. Furthermore, interventions targeting individual modifiable risk factors, particularly throughout the life course, are recommended.
Written by urgent.news from PLOS Medicine's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
