Associations of early retirement and mortality risk: a population-based study in Taiwan

• Published in: Journal of epidemiology and community health (1979) 2024-08, Vol.78 (8), p.522-528
• Main Authors: Wang, Tsui-Hung, Chien, Shao-Yun, Cheng, Wan-Ju, Huang, Ya-Wen, Wang, Shi-Heng, Huang, Wei-Lieh, Tzeng, Ya-Ling, Hsu, Chih-Cheng, Wu, Chi-Shin
• Format: Article
• Language: English
• Subjects: Age; Age Factors; Beneficiaries; Cause of Death; Civil service; Comorbidity; Death; Diabetes; Early retirement; Employment; Farmers; Female; Gastrointestinal diseases; Gender; Health risks; Humans; Hypertension; Labor force; Liver diseases; Male; Mental disorders; Middle Aged; MORTALITY; Mortality - trends; Mortality risk; Neurological diseases; OCCUPATIONAL HEALTH; Occupations; Original research; Population; Population studies; Private sector; PSYCHOLOGY; Regression analysis; Retirees; Retirement; Retirement policies; Risk Factors; Suicide; Survival analysis; Taiwan - epidemiology
• ISSN: 0143-005X; 1470-2738; 1470-2738
• DOI: 10.1136/jech-2024-222075

BackgroundEarly retirement is highly prevalent in Taiwan. This study assesses the association between early retirement and all-cause and cause-specific mortality risks while exploring the modifying effect of sociodemographic factors.MethodsUsing Taiwan’s National Health Insurance Research Database between 2009 and 2019, 1 762 621 early retirees aged 45–64 and an equal number of employed comparators were included. The date and cause of death were identified using the National Death Registry. Cox regression models were used to estimate HRs of early retirement for all-cause mortality and cause-specific mortality. To explore modifying effects, we conducted subgroup analyses based on age groups, sexes, occupation types and general health status (Charlson Comorbid Index score).ResultsThe analysis revealed that early retirees, compared with their concurrently employed counterparts, had a higher mortality risk (adjusted HR (aHR) 1.69, 95% CI (1.67 to 1.71)). Specifically, younger individuals (aged 45–54) (aHR 2.74 (95% CI 2.68 to 2.80)), males (aHR 1.78 (95% CI 1.76 to 1.81)), those in farming or fishing occupations (aHR 2.13 (95% CI 2.06 to 2.21)) or the private sector (aHR 1.92 (95% CI 1.89 to 1.96)), and those with the poorest health conditions (aHR 1.79 (95% CI 1.76 to 1.83)) had higher mortality risks of early retirement. Regarding specific causes of death, the top three highest risks were associated with gastrointestinal disorders, followed by suicide and neurological disorders.ConclusionsThis study underscores the substantial mortality risk increase linked to early retirement, emphasising the importance of policy considerations, particularly regarding vulnerable populations and specific causes of death potentially linked to unhealthy lifestyles.