title: Influence of poor health on exit from paid employment: a systematic review.
abstract: The objective was to provide a systematic literature review on associations between poor health and exit from paid employment through disability pension, unemployment and early retirement, and to estimate the magnitude of these associations using meta-analyses. Medline and Embase databases were searched for longitudinal studies on the relationship between health measures and exit from paid employment. Random-effects models were used to estimate the pooled effects. In total, 29 studies were included. Self-perceived poor health was a risk factor for transition into disability pension (relative risk (RR) 3.61; 95% CI 2.44 to 5.35), unemployment (RR 1.44; 95% CI 1.26 to 1.65) and early retirement (RR 1.27; 95% CI 1.17 to 1.38). Workers with mental health problems had an increased likelihood for transition into disability pension (RR 1.80; 95% CI 1.41 to 2.31) or unemployment (RR 1.61; 95% CI 1.29 to 2.01). Chronic disease was a risk factor for transition into disability pension (RR 2.11; 95% CI 1.90 to 2.33) or unemployment (RR 1.31; 95% CI 1.14 to 1.50), but not for early retirement. This meta-analysis showed that poor health, particularly self-perceived health, is a risk factor for exit from paid employment through disability pension, unemployment and, to a lesser extent, early retirement. To increase sustained employability it should be considered to implement workplace interventions that promote good health.
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Rogier M
authors.initials: RM
authors.lastname: van Rijn
authors.forename: Suzan J W
authors.initials: SJ
authors.lastname: Robroek
authors.forename: Sandra
authors.initials: S
authors.lastname: Brouwer
authors.forename: Alex
authors.initials: A
authors.lastname: Burdorf
mesh_terms: D002908:Chronic Disease; D006233:Persons with Disabilities; D004651:Employment; D006304:Health Status; D006801:Humans; D001523:Mental Disorders; D010415:Pensions; D010465:Perception; D012179:Retirement; D014478:Unemployment