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Original research
Associations of early retirement and mortality risk: a population-based study in Taiwan
  1. Tsui-Hung Wang1,
  2. Shao-Yun Chien2,
  3. Wan-Ju Cheng1,3,
  4. Ya-Wen Huang1,
  5. Shi-Heng Wang1,4,
  6. Wei-Lieh Huang5,6,
  7. Ya-Ling Tzeng7,
  8. Chih-Cheng Hsu8,9,10,
  9. Chi-Shin Wu1,5
  1. 1 National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan
  2. 2 School of Nursing, University of Washington, Seattle, Washington, USA
  3. 3 Department of Public Health, China Medical University, Taichung, Taiwan
  4. 4 Department of Medical Research, China Medical University, Taichung, Taiwan
  5. 5 Department of Psychiatry, National Taiwan University Hospital, Douliou, Yunlin, Taiwan
  6. 6 Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan
  7. 7 School of Nursing, China Medical University College of Medicine, Taichung, Taiwan
  8. 8 Department of Family Medicine, Min Sheng General Hospital, Taoyuan, Taiwan
  9. 9 Department of Health Services Administration, China Medical University, Taichung, Taiwan
  10. 10 Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
  1. Correspondence to Dr Chi-Shin Wu, National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan 350, Taiwan; chishinwu{at}ntu.edu.tw

Abstract

Background Early 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.

Methods Using 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).

Results The 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.

Conclusions This 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.

  • MORTALITY
  • PSYCHOLOGY
  • OCCUPATIONAL HEALTH

Data availability statement

Data may be obtained from a third party and are not publicly available. The datasets supporting this study are available from Taiwan’s Health and Welfare Data Science Centre. Due to legal restrictions, data cannot be made publicly available. Requests for data can be sent as a formal proposal to Taiwan’s Health and Welfare Data Science Centre (https://dep.mohw.gov.tw/dos/mp-113.html).

https://doi.org/10.1136/jech-2024-222075

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    Data availability statement

    Data may be obtained from a third party and are not publicly available. The datasets supporting this study are available from Taiwan’s Health and Welfare Data Science Centre. Due to legal restrictions, data cannot be made publicly available. Requests for data can be sent as a formal proposal to Taiwan’s Health and Welfare Data Science Centre (https://dep.mohw.gov.tw/dos/mp-113.html).

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    Footnotes

    • Contributors All authors contributed to the study’s conception and design. Y-WH and C-SW performed data management and analysis. T-HW and S-YC wrote the first draft of the manuscript. C-SW is the guarantor for the study. All authors commented on previous versions and approved the final manuscript. During the preparation of this work, the authors used ChatGPT 3.5 and Grammarly to correct grammar and improve writing. After using these services, the authors reviewed and edited the content as needed and took full responsibility for the publication’s content.

    • Funding This work was supported by the National Health Research Institutes, Taiwan (CG-111-GP-01, CG-112-GP-01, received by C-SW).

    • 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.