title: Health as a predictor of early retirement before and after introduction of a flexible statutory pension age in Finland.
abstract: Little is known of how pension reforms affect the retirement decisions of people with different health statuses, although this is crucial for the understanding of the broader societal impact of pension policies and for future policy development. We assessed how the Finnish statutory pension age reform introduced in 2005 influenced the role of health as a predictor of retirement.
  
  
  
  We used register-based data and cox regression analysis to examine the association of health (measured by purchases of psychotropic medication, hospitalizations due to circulatory and musculoskeletal diseases, and the number of any prescription medications) with the risk of retirement at age 63-64 among those subject to the old pension system with fixed age limit at 65 (pre-reform group born in 1937-1941) and the new flexible system with 63 as the lower age limit (post-reform group born in 1941-1945) while controlling for socio-demographic factors.
  
  
  
  Retirement at age 63-64 was more likely among the post- than the pre-reform group (HR = 1.50; 95% CI 1.43-1.57). This reform-related increase in retirement was more pronounced among those without a history of psychotropic medication or hospitalizations due to circulatory and musculoskeletal diseases, as well as among those with below median level medication use. As a result, poor health became a weaker predictor of retirement after the reform.
  
  
  
  Contrary to the expectations of the Finnish pension reform aimed at extending working lives, offering choice with respect to the timing of retirement may actually encourage healthy workers to choose earlier retirement regardless of the provided economic incentives for continuing in work.
authors.affiliation: Population Research Unit, Department of Social Research, University of Helsinki, P.O. Box 18, 00014 University of Helsinki, Finland. Electronic address: taina.leinonen@helsinki.fi.
authors.forename: Taina
authors.initials: T
authors.lastname: Leinonen
authors.affiliation: Finnish Centre for Pensions, ELÄKETURVAKESKUS, FI-00065, Finland.
authors.forename: Mikko
authors.initials: M
authors.lastname: Laaksonen
authors.affiliation: Cathie Marsh Institute, School of Social Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
authors.forename: Tarani
authors.initials: T
authors.lastname: Chandola
authors.affiliation: Population Research Unit, Department of Social Research, University of Helsinki, P.O. Box 18, 00014 University of Helsinki, Finland; Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, SE-106 91 Stockholm, Sweden; Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057 Rostock, Germany.
authors.forename: Pekka
authors.initials: P
authors.lastname: Martikainen
mesh_terms: D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005387:Finland; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health / Q000592:standards / Q000706:statistics & numerical data; D010415:Pensions / Q000706:statistics & numerical data; D012042:Registries; D012044:Regression Analysis; D012179:Retirement / Q000706:statistics & numerical data / Q000639:trends*; D012307:Risk Factors; D013997:Time Factors
keywords: Finland; Health; Hospital admissions; Pension reform; Prescription medication; Retirement decisions