Time to retire--time to die? A prospective cohort study of the effects of early retirement on long-term survival.

In a long-term prospective cohort study we try to assess selective and protective impacts of early retirement on life expectancy. The results are based on the members of a compulsory German health insurance fund (Gmünder Ersatzkasse). We analyzed 88,399 men and 41,276 women who retired between the ages of 50 and 65 from January 1990 to December 2004. Our main outcome measures are hazard ratios for death adjusted for age, sex, marital and socioeconomic status, year of observation, age at retirement, hospitalization, and form of retirement scheme. We found a significantly higher mortality risk among pensioners with reduced earning capacities than among old-age pensioners who either left the labor market between the ages of 56 and 60 or between 61 and 65. The youngest male and female pensioners who left the labor market between the ages of 51 and 55 because of their reduced earning capacity faced the highest mortality risk. But healthy people who retire early do not experience shorter long-term survival than those who retire late. On the contrary, if we take into consideration the amount of days spent in hospital during the last 2 years prior to retirement, early retirement in fact lowers mortality risks significantly by 12% for men and by 23% for women. Thus with respect to mortality, early retirement reflects both selective and protective processes. First of all, individuals with poor health and lower survival chances are filtered out of the labor market. However, healthy pensioners may be protected during retirement. For the former, early retirement is a necessity, for the latter it is an asset. Pension reformers should take health differentials into consideration when cutting back pension programs and increasing retirement age.