Being out of work harms your health – even if it's because you've retired

A new report finds that, after a small boost in health, retirement isn't as refreshing as many think.

A curious thing has been happening with regard to retirement patterns in developed countries: we have been living longer and retiring earlier. Between 1968 and 1999, employment amongst 60-64 year old men fell from 80 per cent to 50 per cent – although it has picked up a little since. In Italy, an incredible 80 per cent of 60-64 year olds are not in employment. This has all happened during a period when life expectation has increased dramatically. In many EU countries, a significant number of people could well spend more time in retirement than working.

Of course, as we get more prosperous we would expect to have more leisure. But there comes a point when financing a longer retirement from a shorter working life becomes unsustainable. Most EU countries, with their state pension schemes designed so that the taxes of the declining working generation pay the pensions of the older generation, have reached the point where huge financial burdens are likely to fall on the next generation of workers. One way to square the circle is to promote more private and funded pension provision. However, one of the few countries that was pursuing this policy – the UK – has now decided to change tack and increase state pensions whilst reducing incentives for private provision.

This leaves working longer as the only safety valve in the system. And many countries have, indeed, been raising state pension ages. However, a concern often expressed by those campaigning against such changes is that it will lead to more ill health. It is argued that people will suffer from stress and will not have the physical capacity to continue their working lives without damaging their health further.

Much of the evidence in this area has been mixed. The indications were that retirement and ill health were correlated but it could be that people who are not well tend to retire early. A new IEA study manages to untangle the evidence. It finds that there can be an immediate “holiday effect” from retirement whereby health improves. However, health then deteriorates after a while. It is found that, over the long term, retirement increases the probability of suffering from depression by 40 per cent and the probability of having at least one diagnosed physical condition by about 60 per cent.

This provides considerable evidence that there can be a “win-win” from the government raising the state pension age much more rapidly. Currently, the government expects to raise the state pension age to 68 by about 2047. By that time, in fact, life expectation at retirement will actually increase – longevity is increasing quicker than the state pension age is being raised. A higher state pension age could lower healthcare costs as well as reduce state pension costs. Secondly, the government should deregulate labour markets – especially for older people. Reducing the risks to employers of hiring older people is likely to widen the range of working opportunities available to them – especially with regard to part-time work. Finally, it is important to ensure that state incapacity benefits are used as a route back into work wherever possible and not used as an early retirement option. The government seems to be making good progress here but, if anything, on the first two policy options it seems to be going backwards.

A notable retiree says goodbye to his old workplace. Photograph: Getty Images

Philip Booth is Editorial and Programme Director at the Institute of Economic Affairs.

 

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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear