The Lancet Public Health Volume 5, ISSUE 7, e395-e403, July 01, 2020
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Background
Retirement ages are rising in many countries to offset the challenges of population ageing, but people’s capacity to work for more years in their later working life (>50 years) is unclear. We aimed to estimate healthy working life expectancy in England.
Methods
This analysis included adults aged 50 years and older from six waves (2002–13) of the English Longitudinal Study of Ageing (ELSA), with linked mortality data. Healthy working life expectancy was defined as the average number of years expected to be spent healthy (no limiting long-standing illness) and in paid work (employment or self-employment) from age 50 years. Healthy working life expectancy was estimated for England overall and stratified by sex, educational attainment, deprivation level, occupation type, and region by use of interpolated Markov chain multi-state modelling.
Findings
There were 15 284 respondents (7025 men and 8259 women) with survey and mortality data for the study period. Healthy working life expectancy at age 50 years was on average 9·42 years (10·94 years [95% CI 10·65–11·23] for men and 8·25 years [7·92–8·58] for women) and life expectancy was 31·76 years (30·05 years for men and 33·49 years for women). The number of years expected to be spent unhealthy and in work from age 50 years was 1·84 years (95% CI 1·74–1·94) in England overall. Population subgroups with the longest healthy working life expectancy were the self-employed (11·76 years [95% CI 10·76–12·76]) or those with non-manual occupations (10·32 years [9·95–10·69]), those with a tertiary education (11·27 years [10·74–11·80]), those living in southern England (10·73 years [10·16–11·30] in the South East and 10·51 years [9·80–11·22] in the South West), and those living in the least deprived areas (10·53 years [10·06–10·99]).
Interpretation
Healthy working life expectancy at age 50 years in England is below the remaining years to State Pension age. Older workers of lower socioeconomic status and in particular regions in England might benefit from proactive approaches to improve health, workplace environments, and job opportunities to improve their healthy working life expectancy. Continued monitoring of healthy working life expectancy would provide further examination of the success of such approaches and that of policies to extend working lives.