Trajectories in physical functioning by occupational class among retiring women: the significance of type of retirement and social and health-related factors

J Epidemiol Community Health. 2023 Jun;77(6):362-368. doi: 10.1136/jech-2022-219963. Epub 2023 Apr 7.

Abstract

Background: Occupational class inequalities in physical functioning and their changes after retirement are poorly understood. We examined occupational class trajectories in physical functioning 10 years before and after transition to old-age and disability retirement. We included working conditions and behavioural risk factors as covariates, given their established link to health and retirement.

Methods: We used the Helsinki Health Study cohort data from surveys 2000-2002 to 2017, and included 3901 women, who were employed by the City of Helsinki, Finland, and retired during the follow-up. Mixed-effect growth curve models were used to examine changes in RAND-36 Physical Functioning subscale (range 0-100) 10 years before and after the retirement date by occupational class.

Results: Old-age (n=3073) and disability retirees (n=828) lacked class differences in physical functioning 10 years before retirement. By retirement transition, physical functioning declined and class inequalities emerged, the predicted scores being 86.1 (95% CI 85.2 to 86.9) for higher class and 82.2 (95% CI 81.5 to 83.0) for lower class old-age retirees, and 70.3 (95% CI 67.8 to 72.9) for higher class and 62.2 (95% CI 60.4 to 63.9) for lower class disability retirees. Physical functioning declined and class inequalities slightly widened among old-age retirees after the retirement, whereas among disability retirees the decline plateaued and class inequalities narrowed over time after retirement. Physical work and body mass index somewhat attenuated the class inequalities after adjustment.

Conclusions: Class inequalities in physical functioning widened after old-age retirement and narrowed after disability retirement. The examined work and health-related factors contributed weakly to the inequalities.

Keywords: AGING; COHORT STUDIES; GERONTOLOGY; Health inequalities; SOCIAL CLASS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Disabled Persons*
  • Female
  • Finland / epidemiology
  • Health Inequities
  • Humans
  • Retirement*
  • Risk Factors
  • Social Class
  • Social Determinants of Health
  • Surveys and Questionnaires