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Trajectories in physical functioning by occupational class among retiring women: the significance of type of retirement and social and health-related factors
  1. Tea Lallukka1,
  2. Eero Lahelma1,
  3. Olli Pietiläinen1,
  4. Susan Kuivalainen2,
  5. Mikko Laaksonen2,
  6. Ossi Rahkonen1,
  7. Jouni Lahti1,3
  1. 1 Department of Public Health, University of Helsinki, Helsinki, Finland
  2. 2 Finnish Centre for Pensions, Helsinki, Finland
  3. 3 Finnish Institute for Health and Welfare (THL), Helsinki, Finland
  1. Correspondence to Professor Tea Lallukka, Department of Public Health, University of Helsinki, 00014 Helsinki, Finland; tea.lallukka{at}helsinki.fi

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.

  • SOCIAL CLASS
  • AGING
  • COHORT STUDIES
  • GERONTOLOGY
  • Health inequalities

Data availability statement

No data are available. Data cannot be openly shared due to data protection laws and regulations. Data are available for members of the group on reasonable request, pending following the GDPR. More information is available at the project website (data protection statement):https://www.helsinki.fi/en/researchgroups/helsinki-health-study/data-protection-statement.

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Data availability statement

No data are available. Data cannot be openly shared due to data protection laws and regulations. Data are available for members of the group on reasonable request, pending following the GDPR. More information is available at the project website (data protection statement):https://www.helsinki.fi/en/researchgroups/helsinki-health-study/data-protection-statement.

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Footnotes

  • Twitter @TeaLallukka

  • Contributors TL, OP and JL conceived and designed the study. EL, SK, ML and OR contributed to the planning of the study. OP carried out all the data analyses. TL and JL wrote the manuscript with input from EL. TL acts as guarantor and acquired the funding. All other authors (OP, SK, ML and OR) reviewed and commented the manuscript, participated in the interpretation of the results and helped produce the revised version. All authors meet authorship criteria and no one meeting the authorship criteria has been omitted from the author list.

  • Funding This study was supported by the Finnish Centre for Pensions (grant number not applicable). TL, JL and OP were supported by the Academy of Finland (grant #330527). OR was supported by the Juho Vainio Foundation (grant #201920016).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.