Changes in healthy and unhealthy working-life expectancy over the period 2002–17: a population-based study in people aged 51–65 years in 14 OECD countries

Abstract

Summary: Background: In response to population ageing, most countries within the Organisation for Economic Co-operation and Development (OECD) are planning increases to their pension age. To ensure the effectiveness of such measures, scholars have advocated for continued monitoring of healthy working-life expectancy. However, estimates are limited to a few countries during limited periods of time. Our study aims to estimate healthy and unhealthy working-life expectancy in 14 OECD countries at three points in time between 2002 and 2017. Methods: In this population-based study, we used cross-sectional data from nationally representative surveys on ageing that were representative of the population aged 51–65 years in England, the USA, and 11 European countries plus Israel. European countries, except for England, and Israel were divided into two groups according to their score on the Active Ageing Index (AAI). We estimated healthy and unhealthy working-life expectancy, defined as the number of years spent working in good or in poor health. Poor health was defined as the presence of at least one chronic disease. Sullivan's method was used to estimate expectancies. Findings: Among men, healthy working-life expectancy increased in low-AAI countries (4·15 in 2002, 95% CI 4·01–4·30; vs 4·73 in 2017, 4·58–4·87; p<0·0001), but decreased in the USA (3·68 in 2002, 3·47–3·89; vs 3·21 in 2017, 3·03–3·38; p<0·0001). Among women, healthy working-life expectancy increased in England (3·55 in 2002, 3·39–3·71; vs 4·47 in 2017, 4·14–4·81; p<0·0001), high-AAI countries (4·16 in 2002, 4·02–4·30; vs 4·80 in 2017, 4·65–4·96; p<0·0001), and low-AAI countries (2·41 in 2002, 2·30–2·52; vs 4·00 in 2017, 3·88–4·12; p<0·0001). Unhealthy working life expectancy increased among men and women in all countries. In all countries, the greatest number of years spent unhealthy and working was among men and women with hypertension or arthritis. Interpretation: Across countries, increases in the total number of years spent working were systematically accompanied by increases in the number of years spent working with a chronic disease. The burden of chronic diseases will probably continue to increase among older workers as countries plan to further increase their pension ages, but prevention of hypertension and arthritis could mitigate this trend. Funding: Netherlands Interdisciplinary Demographic Institute (NIDI-KNAW) and University of Groningen.