Gendered employment trajectories and later life health in liberal regime countries: A quantitative study in the United States, England, Switzerland and Chile

• Published in: Health policy (Amsterdam) 2024-11, Vol.152, p.105216, Article 105216
• Main Authors: Cabib, Ignacio, Azar, Ariel, Baumann, Isabel, Biehl, Andr, Corna, Laurie, Mautz, Eric, Yopo-Díaz, Martina
• Format: Article
• Language: English
• Subjects: Employment; Gender; Later life; Life course; Welfare state
• ISSN: 0168-8510; 1872-6054; 1872-6054
• DOI: 10.1016/j.healthpol.2024.105216

•Positive health is consistently explained by standard employment histories.•Poor health is consistently explained by non-standard employment histories.•Women do not benefit to the same extent as men from standard trajectories.•Men in non-standard trajectories are clearly penalized in terms of health.•Liberal regime countries render employment and gender crucial for health similarities. We explore the association between adulthood employment patterns and later life health among men and women in four liberal regime countries: two from Europe (England and Switzerland) and two from the Americas (United States and Chile). We carefully harmonized life-history data from the surveys SHARE (N = 1,143), HRS (N = 4,006), ELSA (N = 3,083), and EVDA (N = 802). The samples included individuals born between 1944 and 1954, with information on employment histories from age 15 to 65 and on 11 health outcomes in later life. In line with welfare regime and health literature, we find significant differences in health outcomes between countries, which are likely explained by differences in health systems. However, we extend previous literature by showing that positive health outcomes are consistently explained by standard employment histories, and poor health outcomes are consistently explained by non-standard employment histories. Importantly, men and women following the same employment pathway across countries are either similarly penalized or compensated in their health. This suggests that it is not gender per se that affects health in later life, but the employment trajectory experienced. Nonetheless, women are disproportionately more likely to experience non-standard employment and thus suffer a greater health disadvantage. Policy measures to mitigate negative health effects of non-standard employment trajectories may therefore pay attention to the specific reasons why women are more likely to experience non-standard trajectories.